What are the recommended eye drops for treating conjunctivitis?

From the Guidelines

For treating conjunctivitis, the recommended eye drops depend on the type of infection, with antihistamine eye drops like ketotifen (Zaditor) or olopatadine (Pataday) being effective for allergic conjunctivitis, as supported by the most recent study 1. When considering treatment options, it's essential to identify the cause of conjunctivitis to provide targeted therapy.

• Bacterial conjunctivitis can be treated with antibiotic eye drops such as Polymyxin B-trimethoprim (Polytrim), erythromycin, or fluoroquinolones like ciprofloxacin or moxifloxacin, applied as directed, usually 1-2 drops in the affected eye(s) every 4-6 hours for 5-7 days.
• Viral conjunctivitis, which is most common, typically resolves on its own within 1-2 weeks with artificial tears for comfort and cold compresses.
• Allergic conjunctivitis responds well to antihistamine eye drops, which can be used twice daily, as mentioned in the study 1. It's crucial to follow proper hygiene when using eye drops, including washing hands thoroughly before and after application, avoiding touching the dropper tip to prevent contamination, and gently pulling down the lower eyelid to create a pocket for the drops, as indiscriminate use of topical antibiotics or corticosteroids should be avoided, as they can induce toxicity or worsen certain infections, as noted in the study 1. If symptoms worsen or don't improve within 48-72 hours of treatment, consulting a healthcare provider for a different treatment approach may be necessary, highlighting the importance of early detection and treatment, which can be both sight saving and, in select cases, lifesaving, as emphasized in the study 1.

From the FDA Drug Label

Moxifloxacin ophthalmic solution, 0.5% is indicated for the treatment of bacterial conjunctivitis caused by susceptible strains of the following organisms: Gatifloxacin ophthalmic solution is a quinolone antimicrobial indicated for the treatment of bacterial conjunctivitis caused by susceptible strains of the following organisms: The recommended dosage regimen for the treatment of bacterial conjunctivitis is: Days 1 and 2 Instill one to two drops every two to four hours in the affected eye(s)

The recommended eye drops for treating conjunctivitis are:

• Moxifloxacin ophthalmic solution, 0.5% 2
• Ofloxacin ophthalmic solution 3
• Gatifloxacin ophthalmic solution, 0.5% 4 Key points:
• Moxifloxacin: Instill one drop in the affected eye 3 times a day for 7 days
• Ofloxacin: Instill one to two drops every two to four hours in the affected eye(s) on Days 1 and 2, and one to two drops four times daily on Days 3 through 7
• Gatifloxacin: Instill one drop every two hours in the affected eye(s) while awake, up to 8 times on Day 1, and one drop two to four times daily in the affected eye(s) while awake on Days 2 through 7

From the Research

Recommended Eye Drops for Conjunctivitis

The following are some of the recommended eye drops for treating conjunctivitis:

• Moxifloxacin 0.5% ophthalmic solution: This eye drop has been shown to be effective in treating bacterial conjunctivitis, with a clinical success rate significantly higher than placebo 5.
• Gatifloxacin ophthalmic solution: This eye drop is a broad-spectrum antibiotic with good activity against Staphylococcus aureus, Streptococcus species, and Gram-negative pathogens, making it a suitable choice for treating bacterial conjunctivitis 6.
• Antihistamine eye drops: These are used to treat allergic conjunctivitis, with topical antihistamines and mast cell stabilizers being the treatment of choice 7, 8.

Key Considerations

When choosing an eye drop for conjunctivitis, consider the following:

• The cause of the conjunctivitis: Viral, bacterial, or allergic 7, 8.
• The severity of the symptoms: Mild, moderate, or severe 8.
• The patient's age and medical history: Certain eye drops may be more suitable for certain age groups or medical conditions 9, 5.
• The potential for antibiotic resistance: Choose an eye drop with a good resistance profile, such as moxifloxacin or gatifloxacin 9, 6.

Treatment Approaches

Different treatment approaches may be recommended depending on the cause and severity of the conjunctivitis:

• Supportive care: Artificial tears, cold compresses, and antihistamine eye drops may be used to treat viral conjunctivitis 8.
• Topical antibiotics: May be used to treat bacterial conjunctivitis, with moxifloxacin and gatifloxacin being suitable options 9, 5, 6.
• Delayed antibiotic prescribing: May be considered for mild cases of bacterial conjunctivitis, with similar symptom control to immediate prescribing 8.