TY - JOUR T1 - Acute infective conjunctivitis in primary care: who needs antibiotics? An individual patient data meta-analysis JF - British Journal of General Practice JO - Br J Gen Pract SP - e542 LP - e548 DO - 10.3399/bjgp11X593811 VL - 61 IS - 590 AU - Joanna Jefferis AU - Rafael Perera AU - Hazel Everitt AU - Henk van Weert AU - Remco Rietveld AU - Paul Glasziou AU - Peter Rose Y1 - 2011/09/01 UR - http://bjgp.org/content/61/590/e542.abstract N2 - Background Acute infective conjunctivitis is a common problem in primary care, traditionally managed with topical antibiotics. A number of clinical trials have questioned the benefit of topical antibiotics for patients with acute infective conjunctivitisAim To determine the benefit of antibiotics for the treatment of acute infective conjunctivitis in primary care and which subgroups benefit mostDesign An individual patient data meta-analysisMethod Relevant trials were identified and individual patient data gathered for meta-analysis and subgroup analysisResults Three eligible trials were identified. Individual patient data were available from all primary care trials and data were available for analysis in 622 patients. Eighty per cent (246/308) of patients who received antibiotics and 74% (233/314) of controls were cured at day 7. There was a significant benefit of antibiotics versus control for cure at seven days in all cases combined (risk difference 0.08, 95% confidence interval (CI) = 0.01 to 0.14). Subgroups that showed a significant benefit from antibiotics were patients with purulent discharge (risk difference 0.09, 95% CI = 0.01 to 0.17) and patients with mild severity of red eye (risk difference 0.10, 95% CI = 0.02 to 0.18), while the type of control used (placebo drops versus nothing) showed a statistically significant interaction (P=0.03)Conclusion Acute conjunctivitis seen in primary care can be thought of as a self-limiting condition, with most patients getting better regardless of antibiotic therapy. Patients with purulent discharge or a mild severity of red eye may have a small benefit from antibiotics. Prescribing practices need to be updated, taking into account these results ER -