Sometimes you have national organisations that provide advice about antibiotics, and you have doctors wanting to follow that advice, and you have patients who want to follow that advice, but a stupid rule by eg childcare means that everyone caves and prescribes antibiotics when they're not needed.
> Acute infective conjunctivitis is common among preschool children. Public Health England (PHE) recommends that children with conjunctivitis do not need to be excluded from child care, but childcare providers are required to determine their own sickness policies and prior research suggests that children are often excluded until they are treated or have recovered. How the content of these policies impacts on prescribing decisions has not been quantified.
[...]
> Acute infective conjunctivitis (AIC) is a common condition in preschool children.1 It is usually mild and self-limiting, often with no requirement for treatment or a doctor’s appointment.2 Evidence suggests, however, that parents and guardians are advised by childcare providers (CPs) to take their children with conjunctivitis to their GP for assessment.3–5 Furthermore, some CPs will not permit affected children to return to child care until antibiotics have been prescribed,3,4,6,7 thus parents are obtaining antibiotics to get their child readmitted. A situation in which antibiotics are prescribed for non-clinical reasons is difficult to justify and requires further investigation.
> Although most cases (50–75%) of AIC are bacterial in origin,8 the aetiology is difficult to determine clinically and only 36% of doctors are confident in differentiating between viral and bacterial conjunctivitis.9,10 In bacterial conjunctivitis, there may be some clinical benefit obtained from topical antibiotics;11 however, this benefit is perhaps not seen in children and topical chloramphenicol shortens the duration of symptoms by only 0.3 days.2 Despite this, most clinicians usually prescribe antibiotics for AIC.10
Here's a particularly frustrating example.
http://bjgp.org/content/early/2016/07/05/bjgp16X686125
> Acute infective conjunctivitis is common among preschool children. Public Health England (PHE) recommends that children with conjunctivitis do not need to be excluded from child care, but childcare providers are required to determine their own sickness policies and prior research suggests that children are often excluded until they are treated or have recovered. How the content of these policies impacts on prescribing decisions has not been quantified.
[...]
> Acute infective conjunctivitis (AIC) is a common condition in preschool children.1 It is usually mild and self-limiting, often with no requirement for treatment or a doctor’s appointment.2 Evidence suggests, however, that parents and guardians are advised by childcare providers (CPs) to take their children with conjunctivitis to their GP for assessment.3–5 Furthermore, some CPs will not permit affected children to return to child care until antibiotics have been prescribed,3,4,6,7 thus parents are obtaining antibiotics to get their child readmitted. A situation in which antibiotics are prescribed for non-clinical reasons is difficult to justify and requires further investigation.
> Although most cases (50–75%) of AIC are bacterial in origin,8 the aetiology is difficult to determine clinically and only 36% of doctors are confident in differentiating between viral and bacterial conjunctivitis.9,10 In bacterial conjunctivitis, there may be some clinical benefit obtained from topical antibiotics;11 however, this benefit is perhaps not seen in children and topical chloramphenicol shortens the duration of symptoms by only 0.3 days.2 Despite this, most clinicians usually prescribe antibiotics for AIC.10