Chloramphenicol is an antibiotic that kills a wide range of bacteria and is commonly prescribed for treating infective conjunctivitis.Chloramphenicol eye drops and eye ointment have been available over-the-counter (OTC) from UK pharmacies as a treatment for conjunctivitis since 2005. Using chloramphenicol to treat conjunctivitis can shorten the duration of the condition slightly, but most people recover within a week whether it is used or not.

It may be appropriate to treat troubling infective conjunctivitis as long as there is no reason to refer the patient to a doctor. Royal Pharmaceutical Society guidance says that when making a supply of OTC chloramphenicol, pharmacists need to be satisfied that it is in line with the marketing authorisation and is clinically beneficial. It is crucial for pharmacists to make sure a supply of chloramphenicol is appropriate and to rule out serious sight-threatening conditions.

It is also important to discuss the pros and cons of treatment with the patient. OTC chloramphenicolmust not be used in children aged under two years. The following points need to be considered and discussed with the patient:

• Conjunctivitis can be caused by viruses or bacteria. It is not possible to know the cause just by looking. If caused by a virus, chloramphenicol will have no effect
• Conjunctivitis usually gets better on its own within a week whether treated or not
• Chloramphenicol can help speed up recovery slightly (by a day or so)
• Some people may have side effects from treatment (e.g. stinging, allergy)
• Antibiotics must be used responsibly to limit the development of bacterial resistance.