From the Guidelines
Bacterial conjunctivitis is typically treated with antibiotic eye drops or ointments, such as fluoroquinolones, which are recommended as the first-line treatment due to their broad-spectrum activity and effectiveness against common bacterial pathogens 1. The standard regimen involves applying the drops 4 times daily or ointment 2-3 times daily for 5-7 days, even if symptoms improve earlier to ensure complete eradication of the bacteria. Some key points to consider when treating bacterial conjunctivitis include:
- The use of topical antibiotics, which can reduce the duration of symptoms and improve outcomes 1
- The importance of good hygiene practices, such as washing hands frequently and avoiding sharing towels or pillowcases, to prevent the spread of infection
- The need to avoid touching the tip of the container to any surface to prevent contamination
- The recommendation to replace eye makeup and avoid sharing makeup or makeup brushes to prevent the spread of infection
- The importance of seeking medical attention if symptoms worsen or do not improve with treatment, as some types of conjunctivitis can be associated with systemic diseases and may require systemic drug treatment 1. When using eye drops, it is essential to tilt your head back, pull down your lower eyelid to form a pocket, place the drop in this pocket, close your eyes for 1-2 minutes, and press gently on the inner corner of your eye to prevent systemic absorption. For ointments, apply a small ribbon inside the lower eyelid. Bacterial conjunctivitis is caused by pathogens like Staphylococcus aureus, Streptococcus pneumoniae, or Haemophilus influenzae, and antibiotics work by killing these bacteria or preventing their reproduction, allowing the eye's natural defenses to clear the infection.
From the FDA Drug Label
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). Days 3 through 7 Instill one to two drops four times daily. 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 treatment for bacterial conjunctivitis is:
- Ofloxacin (OPHTH): instill one to two drops every two to four hours in the affected eye(s) for the first two days, then one to two drops four times daily for the next five days 2
- Ciprofloxacin (OPHTH): instill one or two drops into the conjunctival sac(s) every two hours while awake for two days, then one or two drops every four hours while awake for the next five days 3
From the Research
Treatment for Bacterial Conjunctivitis
The treatment for bacterial conjunctivitis typically involves the use of topical antibiotics. Some of the commonly used antibiotics include:
- Lomefloxacin 0.3% 4
- Ofloxacin 0.3% 4
- Besifloxacin 0.6% 5
- Moxifloxacin 0.5% 6, 7
- Gatifloxacin 8
- Levofloxacin 8
Administration and Efficacy
These antibiotics are usually administered in the form of eye drops, with the frequency and duration of treatment varying depending on the specific antibiotic and the severity of the infection. For example:
- Lomefloxacin 0.3% is given 1 drop every 2 hours during waking hours on the first day, then twice daily for one week 4
- Besifloxacin 0.6% is administered three times daily for 5 days 5
- Moxifloxacin 0.5% is administered three times daily for 5 days 6, 7
- Gatifloxacin and levofloxacin are administered two drops per time, eight times per day at the first two days and two drops per time, four times per day at the following 5 days 8
Comparison of Antibiotics
Studies have compared the efficacy of different antibiotics in treating bacterial conjunctivitis, including:
- Lomefloxacin 0.3% vs. ofloxacin 0.3%: both were equally effective and safe in the treatment of acute bacterial conjunctivitis 4
- Besifloxacin 0.6% vs. moxifloxacin 0.5%: besifloxacin was clinically more effective than the vehicle alone and similar to moxifloxacin for bacterial conjunctivitis 5
- Gatifloxacin vs. levofloxacin: both had similar efficacy, but gatifloxacin had a faster and stronger effect in reducing the combination score of signs and symptoms 8