From the Guidelines
Bacterial conjunctivitis should be treated with a 5- to 7-day course of a broad-spectrum topical antibiotic, such as erythromycin ophthalmic ointment, polymyxin B-trimethoprim drops, or fluoroquinolone drops, as this has been shown to reduce morbidity and transmissibility, and allow for an earlier return to school or work 1. The choice of antibiotic is usually empiric, and there is no clinical evidence suggesting the superiority of any particular antibiotic, so the most convenient or least expensive option can be selected. Some key points to consider when treating bacterial conjunctivitis include:
- Applying the medication as directed, usually 1-2 drops in the affected eye(s) every 2-4 hours while awake for drops, or a small ribbon of ointment 3-4 times daily for ointments
- Continuing treatment for 5-7 days, even if symptoms improve sooner
- Practicing good hygiene, such as washing hands frequently, avoiding touching or rubbing the eyes, using separate towels and washcloths, and discarding eye makeup
- Using warm compresses to remove discharge, which should be wiped from the inner corner outward using a clean tissue each time It's also worth noting that povidone-iodine 1.25% ophthalmic solution may be as effective as topical antibiotic therapy for treating bacterial conjunctivitis, and could be considered when access to antibiotics is limited 1. However, the most recent and highest quality study suggests that topical antibiotic therapy is the preferred treatment for bacterial conjunctivitis, as it has been shown to reduce morbidity and transmissibility, and allow for an earlier return to school or work 1.
From the FDA Drug Label
Instill one drop in the affected eye 3 times a day for 7 days. Moxifloxacin ophthalmic solution is for topical ophthalmic use. The recommended dosage regimen for the treatment of bacterial conjunctivitis is one or two drops instilled into the conjunctival sac(s) every two hours while awake for two days and one or two drops every four hours while awake for the next five days.
The recommended treatment for bacterial conjunctivitis is:
- Moxifloxacin ophthalmic solution 0.5%: Instill one drop in the affected eye 3 times a day for 7 days 2
- Ciprofloxacin ophthalmic solution: Instill one or two drops into the conjunctival sac(s) every two hours while awake for two days and one or two drops every four hours while awake for the next five days 3
From the Research
Treatment Options for Bacterial Conjunctivitis
The recommended treatment for bacterial conjunctivitis typically involves the use of topical antibiotics. Several studies have investigated the efficacy of different antibiotics in treating this condition.
- Topical Fluoroquinolones: Studies have shown that topical fluoroquinolones, such as besifloxacin 4, moxifloxacin 5, 6, and lomefloxacin 7, are effective in treating bacterial conjunctivitis. These antibiotics have a broad spectrum of activity and are generally well tolerated.
- Treatment Regimens: The treatment regimens for bacterial conjunctivitis vary depending on the antibiotic used. For example, besifloxacin ophthalmic suspension 0.6% can be administered three times daily for 5 days 4, while moxifloxacin 0.5% ophthalmic solution can be administered three times daily for 5 days 6.
- Efficacy and Safety: The efficacy and safety of these antibiotics have been demonstrated in several clinical trials. For example, a study comparing moxifloxacin 0.5% ophthalmic solution with placebo found that moxifloxacin was significantly more effective in achieving clinical success 6. Another study comparing lomefloxacin 0.3% with ofloxacin 0.3% found that both antibiotics were effective and safe in treating bacterial conjunctivitis, with no significant difference between the two groups 7.
- Resistance and Tolerance: The use of topical fluoroquinolones has raised concerns about the development of resistance. However, studies have shown that the risk of resistance is low, and that these antibiotics can be used safely and effectively in the treatment of bacterial conjunctivitis 5.