What is the treatment for conjunctivitis (inflammation of the conjunctiva)?

From the Guidelines

Conjunctivitis treatment should be directed at the root cause, with a focus on symptom relief and prevention of complications, as emphasized in the most recent guidelines 1. The treatment approach varies depending on the type of conjunctivitis:

• Viral conjunctivitis, the most common type, typically resolves within 1-2 weeks without antibiotics, and treatment focuses on symptom relief with artificial tears and cold compresses 1.
• Bacterial conjunctivitis may require antibiotic eye drops, such as Polytrim or Vigamox, used 3-4 times daily for 5-7 days until symptoms resolve 1.
• Allergic conjunctivitis responds well to antihistamine drops, such as Pataday or Zaditor, and may also involve the use of topical corticosteroids or cyclosporine in severe cases 1. Key principles of conjunctivitis management include:
• Avoiding touching or rubbing eyes
• Washing hands frequently
• Using separate towels
• Discarding eye makeup to prevent spread or reinfection
• Stopping contact lens wear until the infection clears completely
• Seeking medical attention if symptoms worsen, vision becomes affected, or the condition doesn't improve within a week, as more serious eye conditions may require different treatment 1.

From the FDA Drug Label

AzaSite ® is indicated for the treatment of bacterial conjunctivitis caused by susceptible isolates of the following microorganisms: CDC coryneform group G 1 Haemophilus influenzae Staphylococcus aureus Streptococcus mitis group Streptococcus pneumoniae Moxifloxacin ophthalmic solution, 0. 5% is indicated for the treatment of bacterial conjunctivitis caused by susceptible strains of the following organisms: Corynebacterium species* Micrococcus luteus* Staphylococcus aureus Staphylococcus epidermidis Staphylococcus haemolyticus Staphylococcus hominis Staphylococcus warneri* Streptococcus pneumoniae Streptococcus viridans group Acinetobacter lwoffii* Haemophilus influenza Haemophilus parainfluenzae* Chlamydia trachomatis

Treatment Options for Bacterial Conjunctivitis:

• Azithromycin (AzaSite): Instill 1 drop in the affected eye(s) twice daily, eight to twelve hours apart for the first two days and then instill 1 drop in the affected eye(s) once daily for the next five days 2.
• Moxifloxacin: Instill one drop in the affected eye 3 times a day for 7 days 3. Key Considerations:
• Both treatments are for topical ophthalmic use only.
• Patients should be advised not to wear contact lenses if they have signs or symptoms of bacterial conjunctivitis.
• It is essential to complete the full course of therapy to ensure effectiveness and prevent the development of resistance.

From the Research

Conjunctivitis Treatment Overview

• Conjunctivitis is a common eye condition that can be caused by viruses, bacteria, or allergies 4, 5.
• The treatment for conjunctivitis depends on the underlying cause, with viral conjunctivitis typically requiring supportive care, bacterial conjunctivitis often treated with topical antibiotics, and allergic conjunctivitis managed with antihistamines and mast cell stabilizers 4, 5, 6.

Bacterial Conjunctivitis Treatment

• Topical antibiotics can decrease the duration of bacterial conjunctivitis and allow for an earlier return to school or work 4, 6.
• However, the development of antibiotic resistance is a concern, and antibiotics such as gentamycin, tobramycin, and azithromycin are preferred 6.
• Delayed antibiotic prescribing or treatment without antibiotics using artificial tears and eye bathings may be considered in cases of uncomplicated bacterial conjunctivitis 6, 7.

Viral Conjunctivitis Treatment

• Viral conjunctivitis usually does not require treatment, and supportive care options include artificial tears, cold compresses, and antihistamine eye drops 5.
• Strict personal hygiene, including frequent handwashing, is essential to decrease the risk of transmission 5.

Allergic Conjunctivitis Treatment

• Topical antihistamines with mast cell-stabilizing activity are the treatment of choice for allergic conjunctivitis 5.
• Treatment with antihistamines and mast cell stabilizers can alleviate the symptoms of allergic conjunctivitis 4.

Special Considerations

• Conjunctivitis caused by sexually transmitted diseases such as chlamydia and gonorrhea requires systemic treatment in addition to topical antibiotic therapy 4.
• Ophthalmology referral is indicated for conjunctivitis in a neonate or patients with severe pain, decreased vision, recent ocular surgery, vesicular rash on the eyelids or nose, history of rheumatologic disease, or immunocompromised state 5.