From the Guidelines
For bilateral bacterial conjunctivitis in a 15-month-old child, a broad-spectrum topical antibiotic such as polymyxin B-trimethoprim drops or erythromycin ophthalmic ointment is recommended, with the choice of antibiotic being empiric and usually effective with a 5- to 7-day course 1. When selecting an antibiotic, consider the most convenient or least expensive option, as there is no clinical evidence suggesting the superiority of any particular antibiotic 1. Key considerations for treatment include:
- Applying the medication to both eyes, 3-4 times daily for 7-10 days for ointment, or 1 drop in each eye every 3 hours while awake for 7-10 days for drops
- Gently cleaning the child's eyes with warm water and a clean cloth before applying medication, wiping from the inner corner outward
- Pulling down the lower eyelid gently to create a small pocket, placing the medication there, and having the child close their eyes briefly to distribute it
- Washing hands thoroughly before and after treatment to prevent spreading infection It's essential to complete the full course of medication even if symptoms improve, and to contact a doctor if symptoms worsen, if there's increased eye pain, vision changes, or if symptoms don't improve after 2-3 days of treatment.
From the FDA Drug Label
The safety and effectiveness of moxifloxacin ophthalmic solution in treating ophthalmological infections due to these microorganisms have not been established in adequate and well-controlled trials. In a randomized, double-masked, multicenter, parallel-group clinical trial of pediatric patients with bacterial conjunctivitis between birth and 31 days of age, patients were dosed with moxifloxacin ophthalmic solution or another anti-infective agent. Clinical outcomes for the trial demonstrated a clinical cure rate of 80% at Day 9 and a microbiological eradication success rate of 92% at Day 9
For a 15-month-old patient with bilateral bacterial conjunctivitis, moxifloxacin ophthalmic solution can be considered as a treatment option, as it has shown a clinical cure rate of 80% and a microbiological eradication success rate of 92% in pediatric patients with bacterial conjunctivitis 2.
- The dosage regimen for moxifloxacin ophthalmic solution is not explicitly stated in the provided drug label for a 15-month-old patient.
- However, another option is trimethoprim ophthalmic solution, which has a stated dosage regimen for pediatric patients over two months of age, with one drop instilled in the affected eye(s) every three hours (maximum of 6 doses per day) for a period of 7 to 10 days 3.
From the Research
Treatment Options for Bilateral Bacterial Conjunctivitis
- For a 15-month-old child with bilateral bacterial conjunctivitis, topical antibiotics such as azithromycin or fluoroquinolones are usually prescribed 4, 5.
- Moxifloxacin 0.5% administered three times daily has been shown to be safe and effective in treating bacterial conjunctivitis in children, with a faster cure rate compared to polymyxin B sulfate/trimethoprim 6.
- Other treatment options include gentamycin, tobramycin, and polymyxin B sulfate/trimethoprim, although the development of resistance to these antibiotics is a concern 4.
- In some cases, delayed topical antibiotics or treatment without antibiotics using artificial tears and eye bathings may be considered, especially if the infection is mild and self-limiting 4, 7, 8.
Important Considerations
- It is essential to note that bacterial conjunctivitis can be caused by various pathogens, including Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis 5.
- In cases of severe or persistent infection, microbiological testing may be necessary to guide treatment 4, 5.
- Preventive measures, such as screening and treating pregnant women, can help reduce the risk of perinatal transmission of bacterial conjunctivitis 5.