From the Guidelines
The correct treatment for a preschool-age child with bacterial conjunctivitis is topical antibiotic eye drops or ointment, as it reduces transmissibility and allows for an earlier return to school. According to the most recent study 1, a 5- to 7-day course of a broad-spectrum topical antibiotic is usually effective, and the most convenient or least expensive option can be selected. The choice of antibiotic is usually empiric, and there is no clinical evidence suggesting the superiority of any particular antibiotic.
Some key points to consider in the treatment of bacterial conjunctivitis include:
- Cleaning the child's eyes gently with warm water and a clean cloth before each application to remove discharge
- Continuing the medication for the full course even if symptoms improve quickly
- Practicing hand hygiene to prevent spread, and using separate towels and washcloths
- Allowing children to return to school or daycare after 24 hours of antibiotic treatment, as most bacterial conjunctivitis is self-limiting, but antibiotics speed recovery and reduce contagiousness
- Reevaluating the child if symptoms worsen or don't improve after 48-72 hours of treatment, as this could indicate a different pathogen or condition requiring alternative management, as noted in 1 and 1.
It's also important to counsel the child and their family on preventing the spread of the disease, including hand washing and avoiding close contact with others, as emphasized in 1.
From the FDA Drug Label
For the treatment of superficial ocular infections involving the conjunctiva and/or cornea caused by organisms susceptible to erythromycin. In the treatment of superficial ocular infections, erythromycin ophthalmic ointment approximately 1 cm in length should be applied directly to the infected eye(s) up to six times daily, depending on the severity of the infection.
The correct action is to prescribe topical antibiotic drops, such as erythromycin ophthalmic ointment, as the child's symptoms are consistent with bacterial conjunctivitis, which can be treated with topical antibiotics. The key symptoms that support this decision include:
- Yellow-green purulent discharge from both eyes
- Conjunctival erythema
- Matted eyelids in the morning and burning and itching of the eyes The treatment should be applied directly to the infected eye(s) up to six times daily, depending on the severity of the infection 2, 2.
From the Research
Correct Treatment for Bacterial Conjunctivitis
The correct treatment for a preschool-age child with bacterial conjunctivitis presenting with matted eyelids, burning and itching of the eyes, yellow-green purulent discharge, conjunctival erythema, and mild upper respiratory infection (URI) symptoms is:
- Topical antibiotic drops, as they have been shown to decrease the duration of bacterial conjunctivitis and allow for an earlier return to school or work 3, 4, 5, 6, 7
Key Considerations
Some key considerations in the treatment of bacterial conjunctivitis include:
- The use of topical antibiotics, such as azithromycin or fluoroquinolones, which are usually prescribed 3
- The potential for antibiotic resistance, which may necessitate tailored therapy based on antibiotic susceptibility profiles 3
- The importance of treating conjunctivitis caused by gonorrhea or chlamydia with systemic antibiotics, in addition to topical antibiotic therapy 3, 5
Treatment Options
The treatment options for bacterial conjunctivitis are:
- Topical antibiotic drops, which have been shown to be effective in reducing the duration and severity of symptoms 4, 6, 7
- Observation, as many cases of bacterial conjunctivitis are self-limiting and may resolve without treatment 4, 5
- Culture of the conjunctival discharge, which may be necessary in persistent or severe cases to guide treatment 3