Do Ophthalmologists in India Over Prescribing Topical Antibiotics in Acute Infectious Conjunctivitis?

Purpose: To assess the prescribing trends of topical antibiotics for acute infectious conjunctivitis among Ophthalmologists in India and to analyze whether they are using them appropriately or not. Design: Ophthalmologists from various states in India were surveyed by mail using a questionnaire on antibiotic use in acute infective conjunctivitis. Methods: Two hundred fifty ophthalmologists from different parts of India were given printed questionnaire via email. Only 75 responded to the mail. Results of categorical variables were recorded as counts and percentages. Result: The commonest indication for prescribing topical antibiotics was infective conjunctivitis. The most commonly prescribed topical antibiotic was moxifloxacin (65%). The frequency of instillation was 4 times a day by 66.6%. All 75 participants agreed that majority of the cases were viral. 93.4% had the knowledge that majority of infective conjunctivitis are viral in origin and self limiting and that there is no need of antibiotic still then 84% would prescribe antibiotic in viral conjunctivitis. 60% had the opinion that acute bacterial conjunctivitis are mild and resolve on their own without complications. But in spite of this knowledge 94.7% advised an antibiotic in cases of bacterial conjunctivitis. Wait and see policy was adopted by only 8% and 40% took time for patient education. Conclusion: Acute conjunctivitis is mainly viral in origin and self limiting and even among those with a bacterial cause, antibiotics are seldom required. Most of the ophthalmologist surveyed had this knowledge but there was knowledge action mismatch which may promote antibiotic resistance and increase medical costs.