What is the treatment for conjunctivitis?

From the Guidelines

The treatment for conjunctivitis should be directed at the root cause, with early detection and treatment being crucial to prevent complications and improve outcomes, as emphasized in the most recent guidelines 1. The approach to treating conjunctivitis varies based on its cause, which can be bacterial, viral, or allergic.

• For bacterial conjunctivitis, antibiotic eye drops or ointments such as erythromycin, polymyxin B/trimethoprim, or fluoroquinolones are typically prescribed for 5-7 days, as directed by the most recent study 1.
• Viral conjunctivitis, the most common form, generally resolves on its own within 1-2 weeks without specific treatment, though artificial tears can provide symptom relief, as noted in 1.
• For allergic conjunctivitis, antihistamine eye drops like ketotifen or olopatadine, used twice daily, can reduce symptoms, and in some cases, a brief course of topical corticosteroids may be added to the regimen, as suggested in 1. Regardless of the cause, applying cool compresses to closed eyes for 5-10 minutes several times daily helps reduce inflammation and discomfort. It is also important to avoid touching or rubbing the eyes, wash hands frequently, use separate towels and pillowcases, and dispose of eye makeup to prevent spreading the infection. Contact lens wearers should temporarily switch to glasses until the infection clears. If symptoms worsen or don't improve within a few days, or if there are vision changes, severe pain, or light sensitivity, seeking medical attention promptly is advised, as indicated in 1. Simple measures such as wearing sunglasses, using cold compresses, refrigerated artificial tears, avoiding eye rubbing, and avoiding allergens can also be beneficial, as mentioned in 1 and 1.

From the FDA Drug Label

AzaSite ® is indicated for the treatment of bacterial conjunctivitis caused by susceptible isolates of the following microorganisms: The recommended dosage regimen for the treatment of bacterial conjunctivitis is: 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. Moxifloxacin ophthalmic solution, 0. 5% is indicated for the treatment of bacterial conjunctivitis caused by susceptible strains of the following organisms: Instill one drop in the affected eye 3 times a day for 7 days.

The treatment for conjunctivitis is:

• Azithromycin (AzaSite): Instill 1 drop in the affected eye(s) twice daily for the first two days, then 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 points:
• The treatment should be used as directed to avoid development of resistant organisms
• Patients should be advised not to wear contact lenses if they have signs or symptoms of bacterial conjunctivitis
• The treatment is for topical ophthalmic use only and should not be administered systemically or injected subconjunctivally

From the Research

Treatment for Conjunctivitis

The treatment for conjunctivitis varies depending on the cause of the infection. Some key points to consider include:

• Viral conjunctivitis usually does not require treatment and the signs and symptoms at presentation are variable 4
• Bacterial conjunctivitis can be treated with topical antibiotics, which decrease the duration of the infection and allow for an earlier return to school or work 4, 5, 6
• Allergic conjunctivitis can be treated with topical antihistamines and mast cell stabilizers, which alleviate the symptoms of the condition 4, 7
• Conjunctivitis secondary to sexually transmitted diseases such as chlamydia and gonorrhea requires systemic treatment in addition to topical antibiotic therapy 4

Types of Treatment

Some specific types of treatment for conjunctivitis include:

• Azithromycin 1.5% ophthalmic solution, which has been shown to be effective in treating bacterial conjunctivitis 5
• Moxifloxacin 0.5% ophthalmic solution, which has been shown to be effective in treating bacterial conjunctivitis 6
• Topical antihistamines and mast cell stabilizers, which have been shown to reduce symptoms and signs of seasonal allergic conjunctivitis 7

Considerations for Treatment

When considering treatment for conjunctivitis, some key points to keep in mind include:

• The majority of cases of bacterial conjunctivitis are self-limiting and do not require treatment, but conjunctivitis caused by gonorrhea or chlamydia and conjunctivitis in contact lens wearers should be treated with antibiotics 4
• Treatment with empirical topical antibiotics for suspected infectious conjunctivitis is controversial, and should be considered carefully due to the risk of drug resistance, toxicity, and expense 8