What is an inexpensive medication for conjunctivitis (pink eye)?

Inexpensive Medications for Pink Eye (Conjunctivitis)

For bacterial conjunctivitis, a 5-7 day course of a broad-spectrum topical antibiotic such as erythromycin or bacitracin ointment is an effective and inexpensive treatment option. 1, 2, 3

Treatment Based on Type of Conjunctivitis

Bacterial Conjunctivitis

• Mild bacterial conjunctivitis is often self-limiting and may resolve without treatment in immunocompetent adults 1
• When treatment is needed, erythromycin ophthalmic ointment is an effective, inexpensive option for superficial ocular infections involving the conjunctiva 2
• Bacitracin ophthalmic ointment is another cost-effective option for treating superficial conjunctival infections 3
• A 5-7 day course is typically sufficient for most uncomplicated cases 1
• Povidone-iodine 1.25% ophthalmic solution can be an effective alternative when access to antibiotics is limited 1
• Patients should return for evaluation if no improvement is seen after 3-4 days of treatment 1

Viral Conjunctivitis

• Most cases are self-limiting and require only supportive care 1, 4
• Inexpensive supportive options include:
  • Artificial tears (preferably preservative-free) to dilute viral particles and provide comfort 1, 4
  • Cold compresses to reduce inflammation and discomfort 1, 4
• Strict personal hygiene, including frequent handwashing, is essential to prevent transmission 4
• Avoid topical corticosteroids as they can potentially prolong adenoviral infections 1

Allergic Conjunctivitis

• First-line inexpensive treatments include:
  • Cold compresses to reduce inflammation 5
  • Refrigerated artificial tears to dilute allergens and inflammatory mediators 5
  • Over-the-counter topical antihistamine/vasoconstrictor agents for mild cases 5, 1
• Second-generation topical histamine H1-receptor antagonists are more effective but may be more expensive 5, 1
• Topical medications with combined antihistamine activity and mast-cell stabilizing properties are preferred for both acute and chronic disease 1
• Avoid oral antihistamines if possible as they may worsen dry eye syndrome 6, 7

Special Considerations

Gonococcal and Chlamydial Conjunctivitis

• These require systemic antibiotic therapy, not just topical treatment 1
• Sexual contacts should be treated concurrently 1
• Patients with gonococcal conjunctivitis should be seen daily until resolution 6

Corticosteroid Use

• Only use for severe cases not responding to first-line treatments 6, 5
• Monitor intraocular pressure and check for cataract formation when using corticosteroids 6
• Limit use to 1-2 weeks to avoid complications 6, 1

Contact Lens Wearers

• Preservative-free artificial tears are preferred for contact lens wearers 8
• Contact lens wear should be discontinued during active infection 4

When to Refer to an Ophthalmologist

• Immediate referral is indicated for patients with:
  • Visual loss or moderate to severe pain 1
  • Severe purulent discharge or corneal involvement 1
  • Lack of response to therapy or recurrent episodes 1
  • History of immunocompromise 1

Common Pitfalls to Avoid

• Indiscriminate use of topical antibiotics for viral conjunctivitis 1
• Chronic use of vasoconstrictor agents can lead to rebound vasodilation 1
• Using preserved artificial tears too frequently can irritate the eye 8
• Not considering sexually transmitted infections in cases of severe purulent conjunctivitis 1