From the Guidelines
The treatment for conjunctivitis depends on its cause, and it is essential to direct treatment at the root cause to prevent complications and promote recovery. For bacterial conjunctivitis, antibiotic eye drops or ointments like erythromycin, polymyxin B/trimethoprim, or fluoroquinolones are typically prescribed for 5-7 days, as directed, usually 1-2 drops every 2-4 hours 1. Viral conjunctivitis, which is most common, has no specific treatment and resolves on its own within 1-2 weeks; cold compresses and artificial tears can provide symptom relief 1. For allergic conjunctivitis, antihistamine eye drops like ketotifen (Zaditor) or olopatadine (Pataday) can be used twice daily, along with avoiding allergens 1.
Some key points to consider in the treatment of conjunctivitis include:
- Good hygiene is essential: wash hands frequently, avoid touching eyes, use separate towels and pillowcases, and discard eye makeup 1.
- Contact lens wearers should temporarily switch to glasses until symptoms resolve 1.
- If symptoms worsen, vision becomes affected, or there's no improvement after 2-3 days of treatment, seek medical attention as more serious eye conditions can mimic conjunctivitis 1.
- In cases of conjunctivitis associated with systemic diseases, patients should be referred to an appropriate medical specialist for evaluation 1.
It is crucial to note that indiscriminate use of topical antibiotics or corticosteroids should be avoided because antibiotics can induce toxicity and corticosteroids can potentially prolong adenoviral infections and worsen HSV infections 1. Treatment methods should be described for the most common types of conjunctivitis and for those types that are particularly important to treat 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:
- 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
The treatment for conjunctivitis is moxifloxacin ophthalmic solution, which is administered by instilling one drop in the affected eye 3 times a day for 7 days 2.
- The solution is for topical ophthalmic use.
- Gatifloxacin ophthalmic solution is also indicated for the treatment of bacterial conjunctivitis caused by susceptible strains of certain organisms, including Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, and Haemophilus influenzae 3.
- Clinical cure rates of 66% to 69% were observed in patients treated with moxifloxacin ophthalmic solution for bacterial conjunctivitis 2.
From the Research
Treatment Options for Conjunctivitis
The treatment for conjunctivitis depends on the cause of the infection.
- For viral conjunctivitis, treatment is supportive, including artificial tears, cold compresses, and antihistamine eye drops 4, 5.
- For bacterial conjunctivitis, topical antibiotics may be prescribed to decrease the duration of the infection and allow for an earlier return to school or work 4, 6.
- For allergic conjunctivitis, treatment consists of topical antihistamines and mast cell stabilizers to alleviate symptoms 4, 7.
Antibiotic Treatment
- Topical antibiotics are effective in treating bacterial conjunctivitis, especially in cases where the infection is caused by gonorrhea or chlamydia 4, 6.
- Gatifloxacin ophthalmic solution is a broad-spectrum antibiotic that has been shown to be effective in treating bacterial conjunctivitis 6.
Self-Limiting Cases
- Most cases of bacterial conjunctivitis are self-limiting and do not require treatment, resolving on their own within 1-2 weeks 4, 8.
- However, in some cases, such as conjunctivitis caused by gonorrhea or chlamydia, or in contact lens wearers, antibiotic treatment is necessary 4, 5.
Referral to Ophthalmology
- Referral to an ophthalmologist is indicated for conjunctivitis in neonates 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.