Bacterial conjunctivitis usually clears up in 2 to 5 days without treatment, though it can linger for up to 2 weeks. Antibiotic eye drops shorten that timeline, reduce the risk of complications, and help you stop spreading the infection sooner. Here’s what to do, what to expect, and how to keep it from coming back.
Confirm It’s Actually Bacterial
Not all pink eye responds to antibiotics, so getting the type right matters. Bacterial conjunctivitis has a distinct look: thick, yellow or green discharge that crusts your eyelids shut overnight, redness in one or both eyes, and sometimes mild swelling or pain around the lids. The discharge is the key clue. Viral pink eye tends to produce watery, clear discharge instead, and allergic conjunctivitis typically causes intense itching in both eyes with minimal crusting.
If your eyes are red but the discharge is watery and you have cold-like symptoms, you’re likely dealing with a virus, and antibiotics won’t help. The American Academy of Ophthalmology specifically warns against indiscriminate use of antibiotic drops, noting that mild bacterial cases are often self-limiting and viral cases won’t respond to antibacterial treatment at all.
Antibiotic Eye Drops and Ointments
When a doctor confirms or suspects bacterial conjunctivitis, the standard treatment is a broad-spectrum antibiotic eye drop applied two to four times a day for 7 to 10 days. The most commonly prescribed options are fluoroquinolone drops or a combination antibiotic drop. For children or people who have trouble with drops, antibiotic ointments work well, though they temporarily blur vision after application.
You’ll typically notice improvement within the first 24 to 48 hours of starting treatment. The discharge decreases, the redness fades, and your eyelids stop sticking together in the morning. Even if your eyes feel completely normal after a few days, finish the full course your doctor prescribed. Stopping early can let the remaining bacteria rebound.
Home Care That Actually Helps
Antibiotics do the heavy lifting, but daily eyelid hygiene makes a real difference in comfort and healing speed.
- Clean away discharge often. Wash your hands, then use a clean, wet washcloth or a fresh cotton ball to gently wipe crusting and discharge from around your eyes several times a day. Use a new cotton ball for each wipe and each eye. Throw them away immediately after.
- Apply a warm compress. A clean washcloth soaked in warm water and held against your closed eyelids for a few minutes loosens dried discharge and soothes irritation. Use a fresh cloth each time.
- Skip contact lenses. Switch to glasses until the infection is completely resolved and you’ve finished your antibiotic course. Wearing contacts over an infected eye traps bacteria against the surface and can worsen or prolong the infection.
- Avoid touching your eyes. Every time you touch an infected eye and then touch a surface, doorknob, or your other eye, you’re spreading bacteria. If you do need to touch your eye to apply drops or clean it, wash your hands before and after.
How Long You’re Contagious
Bacterial pink eye is contagious from the moment symptoms appear until roughly 48 hours after you start antibiotic treatment. That 48-hour window is the threshold most schools and workplaces use for return policies. If you’re not using antibiotics, you remain contagious as long as your eyes are producing discharge, which can be up to two weeks.
During the contagious period, don’t share towels, pillowcases, or eye makeup. Wash your pillowcase daily if possible. If you live with others, designate your own hand towel and keep it separate.
What to Do With Contacts and Makeup
Any disposable contact lenses you wore before or during the infection should be thrown out. They can harbor bacteria even after soaking in solution, and reinserting them risks reinfection. If you wear reusable lenses, disinfect them overnight and check with your eye doctor before wearing them again. Your lens case should be replaced as well.
The same logic applies to eye makeup. Mascara, eyeliner, and any applicators that touched the infected area can reintroduce bacteria. Replace anything that came near your eyes in the days before and during the infection. It’s a small cost compared to a second round of pink eye.
Signs That Need Urgent Attention
Most bacterial conjunctivitis is mild and resolves without lasting problems. But certain symptoms suggest something more serious is going on, either a deeper eye infection or a condition that mimics pink eye. Seek urgent care if you experience significant eye pain (not just mild irritation), blurred vision that doesn’t clear when you blink away discharge, strong sensitivity to light, or a persistent feeling that something is stuck in your eye. These can signal conditions that require different treatment and shouldn’t be managed at home.
If you’ve been on antibiotic drops for 2 to 3 days and see no improvement at all, that’s also worth a follow-up. The infection may be caused by a resistant strain, or the diagnosis may need to be reconsidered.