Recommended Dosing for Conjunctivitis Treatment
For bacterial conjunctivitis, the recommended dosing is moxifloxacin 0.5% ophthalmic solution instilled as one drop in the affected eye 3 times daily for 7 days. 1
Treatment Recommendations by Conjunctivitis Type
Bacterial Conjunctivitis
- First-line treatment: Topical broad-spectrum antibiotics for 5-7 days 2
- Treatment duration: Continue until:
- Resolution of discharge
- No more matting of eyelids in morning
- Reduction in conjunctival injection 2
- Efficacy: Moxifloxacin shows faster clinical resolution (81% at 48 hours) compared to polymyxin B/trimethoprim (44% at 48 hours) 3
Viral Conjunctivitis
- Primarily supportive care:
- Artificial tears for comfort
- Cold compresses to reduce inflammation
- Strict hygiene measures 2
Allergic Conjunctivitis
- Topical antihistamines with mast cell-stabilizing activity 4
Special Considerations
Neonatal Conjunctivitis
- Requires immediate referral as it may indicate serious infections 2
- Treatment based on time of onset:
- 1-7 days after birth: Consider gonococcal infection
- 5-19 days: Consider chlamydial infection
- First week: Common bacterial infections (S. aureus, Enterococcus, etc.) 2
Contact Lens Wearers
- Discontinue lens wear until infection resolves
- Consider switching to new lenses after resolution 2
Hygiene and Prevention
- Frequent handwashing
- Avoid sharing towels and pillowcases
- Proper disinfection of surfaces 2
When to Refer to an Ophthalmologist
- No improvement after 3-4 days of treatment
- Moderate to severe pain
- Decreased vision
- Corneal involvement
- Recurrent episodes
- History of herpes simplex virus eye disease
- Immunocompromised patients 2
Important Caveats
- Bacterial conjunctivitis is often self-limiting (41% resolve without antibiotics by days 6-10), but treatment speeds resolution and reduces complications 2
- Increasing resistance to fluoroquinolones has been reported, particularly in MRSA isolates 2
- Indiscriminate use of antibiotics can be harmful, as viral conjunctivitis will not respond to antibacterial agents 2
- Delayed antibiotic prescribing may be considered for mild cases 2, 4
- Warm compresses are preferred over cold compresses for bacterial conjunctivitis 2