ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2009
Relative impact of clinical evidence and over-the-counter prescribing on topical antibiotic use for acute infective conjunctivitis.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The public health impact of making chloramphenicol an over-the-counter antibiotic: a systematic literature review.International ophthalmology · 2025Pooled it
- Acute infective conjunctivitis in primary care: who needs antibiotics? An individual patient data meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2011Pooled it
- Ocular Antibiotic Utilisation across Aotearoa/New Zealand.Antibiotics (Basel, Switzerland) · 2023Article
- Antibiotic resistance in ocular bacterial infections: an integrative review of ophthalmic chloramphenicol.Tropical medicine and health · 2023Review
- A Review of the Differential Diagnosis of Acute Infectious Conjunctivitis: Implications for Treatment and Management.Clinical ophthalmology (Auckland, N.Z.) · 2020Review
- Antibiotic treatment of women with uncomplicated cystitis before and after allowing pharmacist-supply of trimethoprim.International journal of clinical pharmacy · 2017Observational
- Adult bacterial conjunctivitis: resistance patterns over 12 years in patients attending a large primary eye care centre in the UK.BMJ open ophthalmology · 2017Article
- Nursery sickness policies and their influence on prescribing for conjunctivitis: audit and questionnaire survey.The British journal of general practice : the journal of the Royal College of General Practitioners · 2016Article
- Enabling factors for antibiotic prescribing for upper respiratory tract infections: perspectives of Lithuanian and Russian general practitioners.Upsala journal of medical sciences · 2013Article
- Pharmacists' attitudes towards an evidence-based approach for over-the-counter medication.International journal of clinical pharmacy · 2012Article
- Systematic risks from chloramphenicol eye drops.The British journal of general practice : the journal of the Royal College of General Practitioners · 2010Article
- The future role of pharmacists in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2009Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute infective conjunctivitis is a common presentation in general practice. In 2005, three placebo-controlled clinical trials showed that use of topical antibiotics had a small effect on time to clinical resolution. In the same year, chloramphenicol eye drops were made available for sale over the counter.
aimTo compare the relative impact of clinical trial evidence and a change to over-the-counter availability on community use of topical chloramphenicol. DESIGN OF STUDY: Observational study using mainly routinely collected data for England.
settingNational prescribing data for England and local data from general practices in Oxfordshire, England.
methodData were collated from three sources: GP prescriptions from the Prescription Pricing Authority, wholesale supply to pharmacists from IMS Health, and an audit of delayed prescribing and non-prescribing from electronic consultation records for acute conjunctivitis, in four general practices.
resultsThe number of general practice prescriptions for topical chloramphenicol fell from 2.3 million in 2004 to 1.9 million in 2007, a reduction of 15.5%. In contrast, over-the-counter sales by pharmacists have increased steadily. The net effect of these changes has been a 47.8% increase in total chloramphenicol use during 2005-2007, with 1.1 million additional packs being used in 2007 compared to 2004.
conclusionMaking an antibiotic available over the counter increases its use substantially. This is in conflict with the important public health message that antibiotic use needs to be reduced to combat resistance. These findings support the views of the Chief Medical Officer that no more antibiotics should currently be made available over the counter.
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