For bacterial pink eye, antibiotics are prescribed to help clear the infection more quickly. But it’s possible for the condition to persist or return.

Pink eye, or conjunctivitis, is a common eye condition with many causes, including viruses and bacteria. It causes itchy, watery eyes, redness, and discharge.

Pink eye caused by an infection with bacteria is known as bacterial conjunctivitis. If you have this type of pink eye, a doctor or healthcare professional may prescribe antibiotic eye drops or ointments. The medication typically starts working within 24 hours.

Even without antibiotics, a mild case of bacterial pink eye almost always improves within 10 days. But it’s possible for the infection to return after treatment.

Read on to learn the reasons why bacterial pink eye could return, what symptoms to look out for, and how to avoid reinfecting yourself.

Most of the time, pink eye goes away within a few days of using antibiotic eye drops or ointment. But sometimes symptoms persist. Symptoms may also appear to be getting better and then suddenly worsen.

There are a few reasons why this could happen:

Pink eye is not bacterial

There are four main causes of pink eye:

  • viral
  • bacterial
  • allergic
  • irritant

Viral pink eye is the most common.

Since the symptoms of each are so similar, it can be hard for a doctor to tell the difference between the various causes of pink eye. It’s possible that a diagnosis of bacterial pink eye isn’t correct and your pink eye has another cause, like a virus. Antibiotics aren’t effective for treating pink eye caused by viruses, allergies, or irritants.

Not following doctor’s instructions

It’s important to follow a doctor’s instructions for taking the antibiotics and to complete the full course of your medication. Missing a dose or not taking your medication on time could reduce its effectiveness and cause the infection to return.

The bacteria are resistant to the antibiotic

Over time, bacteria can become resistant to certain antibiotics. You may need to try a different antibiotic to treat your infection.


You can get bacterial pink eye again by using products that were used near your eye during your infection, such as mascara, makeup brushes, or contact lenses.

Infection has spread to the cornea

If your symptoms worsen or return, it could mean the infection in your conjunctiva has spread to your cornea (the clear outer layer of your eye). An infection in both your conjunctiva and your cornea is called keratoconjunctivitis.


Blepharitis is inflammation of your eyelid. It often creates crusts or flakes on your eyelashes that look like dandruff. Blepharitis can lead to bacterial conjunctivitis that persists for weeks.

Blocked tear duct

A blocked tear duct traps tears in your eyes. This increases your risk of infections like bacterial conjunctivitis and could be the reason for repeated infections.

Underlying illness

People with an underlying illness that weakens their immune system, such as cancer or HIV, might have a more difficult time clearing the infection.


Trachoma is an eye infection caused by a bacterium known as Chlamydia trachomatis. In its early stages, trachoma causes pink eye. As the infection progresses, it causes eye pain, blurred vision, ulcers, and vision loss.

After starting antibiotics, you should start noticing an improvement in your symptoms within 24 hours. But symptoms may take several more days to fully clear up.

These are indications that the antibiotics aren’t working or that your pink eye may have returned:

  • You notice an increase in yellow or green discharge from your eye.
  • You continue to wake up with your eyelids stuck together.
  • You have pain or sensitivity in your eye when looking into a bright light.
  • You develop other symptoms of an infection, such as fever or chills.
  • Your symptoms don’t improve after a couple days.

Keep in mind that the antibiotics used to treat pink eye can also cause side effects that may be similar to the symptoms of pink eye. These may include:

  • stinging
  • itching
  • burning
  • redness

If you notice your symptoms worsen right after taking the antibiotics, you could be having side effects.

If your symptoms worsen after a few days of taking antibiotics, meet with a doctor again to rule out other causes. A doctor may choose to prescribe a different antibiotic or another medication.

If your pink eye is viral rather than bacterial, antibiotics won’t help, but symptoms should resolve on their own within 3 weeks.

Cold compresses and artificial tears can help relieve inflammation and dryness. These can be purchased over the counter without a prescription.

Get medical help if you have conjunctivitis along with any of the following symptoms:

  • pain in your eye
  • sensitivity to light
  • blurred vision
  • any loss of vision
  • symptoms that get worse or don’t improve 24 hours after starting antibiotics

If you have a newborn who has symptoms of conjunctivitis, see a doctor right away. Also see a doctor if you have a weakened immune system and symptoms of pink eye.

Here are some tips to prevent pink eye from returning after taking antibiotics:

  • Wash your hands frequently.
  • Avoid touching your eyes.
  • Change your bedsheets and pillowcases.
  • Wash any towels you used while you had symptoms.
  • Throw out any eye cosmetics or disposable contact lenses you used while you had pink eye.

Antibiotics can help shorten the duration of your symptoms. Here are answers to frequently asked questions about treating bacterial pink eye.

Can pink eye come back after antibiotics?

Yes, it’s possible for bacterial pink eye to come back even after taking antibiotics. Pink eye is highly contagious. You can get it again by using eye makeup, brushes, towels, or contact lenses that were used while you had symptoms.

Is pink eye contagious after antibiotics?

Bacterial pink eye is contagious for as long as symptoms remain. Antibiotics can help shorten the duration of the illness, but you may still be contagious the first couple days after you start taking them. The Centers for Disease Control and Prevention (CDC) recommend staying home from school or work until any symptoms of watery eyes and discharge clear up.

Pink eye is a common eye infection. Most of the time, pink eye is mild and will improve on its own with or without treatment. If your symptoms worsen or don’t go away after taking antibiotics, consult with a doctor or optometrist to rule out any other causes.