From the Guidelines
Treatment for conjunctivitis should be directed at the root cause, with early detection and treatment being crucial for preventing complications and improving outcomes, as emphasized in the 2024 conjunctivitis preferred practice pattern 1. The approach to treatment varies depending on the type of conjunctivitis:
- Bacterial conjunctivitis may be treated with antibiotic eye drops or ointments, such as erythromycin, polymyxin B/trimethoprim, or fluoroquinolones, for 5-7 days, as these have been shown to provide earlier clinical and microbiological remission compared to placebo 2.
- Viral conjunctivitis, the most common type, typically resolves on its own within 1-2 weeks without specific treatment, with supportive care including cold compresses and artificial tears for comfort.
- Allergic conjunctivitis can be treated with antihistamine eye drops, such as ketotifen (Zaditor) or olopatadine (Pataday), used twice daily, and avoiding allergens and using cool compresses can also help, as recommended in the 2024 conjunctivitis preferred practice pattern 3. It is essential to practice good hygiene, including washing hands frequently, avoiding touching eyes, using separate towels, and replacing eye makeup, to prevent the spread of conjunctivitis, and contact lens wearers should temporarily switch to glasses until symptoms resolve, as highlighted in the 2019 conjunctivitis preferred practice pattern 4, 5. If symptoms worsen, vision changes occur, or there's severe pain, seeking immediate medical attention is crucial, as emphasized in the 2024 conjunctivitis preferred practice pattern 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
Instill one drop in the affected eye 3 times a day for 7 days.
The treatment for conjunctivitis is moxifloxacin ophthalmic solution, which should be administered as one drop in the affected eye 3 times a day for 7 days 6.
- The solution is effective against bacterial conjunctivitis caused by susceptible strains of certain organisms.
- It is essential to follow the prescribed dosage and administration instructions to ensure effective treatment.
From the Research
Treatment Options for Conjunctivitis
The treatment for conjunctivitis varies depending on the cause, which can be viral, bacterial, or allergic.
- For viral conjunctivitis, supportive care options include: + Artificial tears 7 + Cold compresses 7 + Antihistamine eye drops 7
- For bacterial conjunctivitis, treatment options include: + Topical antibiotics, which can decrease the duration of the infection and allow for an earlier return to school or work 8 + Delayed antibiotic prescribing, which has been found to have similar symptom control as immediate prescribing 7, 9
- For allergic conjunctivitis, treatment options include: + Topical antihistamines with mast cell-stabilizing activity, which are the treatment of choice 7 + Mast cell stabilizers, which can alleviate symptoms 8, 10 + Dual-action agents, which are commonly used in Europe and the United States for mild subtypes of allergic conjunctivitis 10
Special Considerations
- Conjunctivitis caused by gonorrhea or chlamydia requires systemic treatment in addition to topical antibiotic therapy 8
- Conjunctivitis in contact lens wearers should be treated with antibiotics 8
- Ophthalmology referral is indicated for conjunctivitis in a neonate or patients with severe pain, decreased vision, recent ocular surgery, vesicular rash on the eyelids or nose, history of rheumatologic disease, or immunocompromised state 7