My kids have oink eye AGAIN…. They just went through 2

Has it been both eyes each time or is it only one?

What color is the pus? Is it yellow/green or more white in color?

Are there any non-eye symptoms (eg, coughing, fever, sore throat, nasal congestion, sneezing)?

And no cough? Any recent illness?

Many pediatric ENT's that I know endorse sinus rinses, just make sure you are using filtered water and/or you can trust your water source is clean.

And both eyes every time, and always presents the same way?

How long were they on the antibiotics for?

What antibiotic was it?

It can be a vicious cycle sometimes. How long after starting the antibiotic do you start to notice it resolving?

Sorry for all the questions, just trying to give you the best possible response to your initial question.

Does it seem to be hurting/bothering them? Do you notice them itching or rubbing the eyes (being itchy)?

Yes most general practitioners will prescribe antibiotics right away (unless they are eye doctor in which case we usually do a more thorough overview). I will admit this is very atypical of a bacterial conjunctivitis and even a viral conjunctivitis to be this persistent. Typically with these types of cyclical cases I lean more towards an allergic conjunctivitis. Typically with allergic conjunctivitis we see more a white stringy discharge (as compared to a bacterial conjunctivitis where we typically see a mucopurulent green/yellow constant discharge). Both types will present with a red eye, but allergic types we typically see additional symptoms of watery eyes. 

Most patients do not require antibiotics – With some exceptions, antibiotic treatment of bacterial conjunctivitis is NOT required because the course is usually self-limited. However, because topical antibiotics may shorten the clinical course, the choice of whether to use antibiotics for the treatment of acute bacterial conjunctivitis is driven by patient preferences (for example in back to work or school situations). Nonspecific conjunctivitis usually resolves within a few days without any treatment. However, the eye may feel better faster when it is treated with a lubricant, such as drops or ointments. These products are available without a prescription in most pharmacies. Preservative-free lubricant drops can be used as often as hourly with no side effects. Regular drops with preservatives should only be used up to six times per day.

Simple hygiene measures can help minimize transmission to others:

• Adults or children with bacterial or viral conjunctivitis should not share handkerchiefs, tissues, towels, cosmetics, or bedsheets/pillows with uninfected family or friends.
• Hand washing is an essential and highly effective way to prevent the spread of infection. Hands should be wet with water and plain soap and rubbed together for 15 to 30 seconds. It is not necessary to use antibacterial hand soap. Teach children to wash their hands before and after eating and after touching the eyes, coughing, or sneezing.
• Alcohol-based hand rubs are a good alternative for disinfecting hands if a sink is not available. Hand rubs should be spread over the entire surface of hands, fingers, and wrists until dry, and they may be used several times. These rubs can be used repeatedly without skin irritation or loss of effectiveness.

I would hold off on the antibiotic for now and let's see what comes of it. There is no down-side to holding off on the antibiotic drops for now. I would be curious to know what the full clinical signs/symptoms are without the antibiotic drop.  I would like to check in with you in the morning and see what the eyes were like first waking up (were the eyes stuck together, white discharge or yellow/green, etc.) and then we can further go from there on what steps to take next. If that is okay with you?

No it is not contagious but they may both be more sensitive to the same contagion.

Let me know what's going on in the morning and then we will go from there, go ahead and hold off on the antibiotic for now though so we can better gauge signs/symptoms.

Okay sounds good, talk to you in the morning.