How do GPs diagnose and manage acute infective conjunctivitis? A GP survey

Abstract

Objective: To determine GPs' diagnosis and management of acute infective conjunctivitis (AIC)-one of the commonest but least researched acute infections seen in primary care.

Methods: A postal questionnaire survey of 300 GPs from two Health Authorities in Southern England.

Results: 236 (78%) GPs returned the questionnaire. 92% of those responding felt confident or very confident in the diagnosis of AIC. 95% usually prescribe topical antibiotics for AIC despite 58% stating that they thought at least half of the cases they see are viral in origin and only 36% believing that they could discriminate between bacterial and viral infection. There was considerable variability in GPs' use of individual signs to make the diagnosis of AIC (from 99% using eye discharge to 31% using conjunctival oedema) and in the features used to discriminate viral from bacterial infection (from 87% using type of discharge to 47% using amount of discharge). GPs rarely perform eye swabs or give patient information leaflets to patients with AIC.

Conclusion: Most GPs still prescribe topical antibiotics for most cases of AIC-a condition where only half of the cases are likely to be due to a bacterial infection, and even bacterial infections are self-limiting. Further research is needed to explore the potential benefits and disadvantages of topical antibiotics, and to develop clinical or microbiological methods to help GPs to target antibiotic prescription.