What is the treatment for conjunctivitis (pink eye) in pediatric patients?

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Last updated: April 3, 2025View editorial policy

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From the Guidelines

Conjunctivitis in children can be treated effectively with specific approaches depending on the cause, and for bacterial conjunctivitis, a 5- to 7-day course of a broad-spectrum topical antibiotic is usually effective, as stated in the most recent study 1.

Treatment Approaches

  • For bacterial conjunctivitis, antibiotic eye drops such as polymyxin B-trimethoprim (Polytrim), erythromycin ointment, or tobramycin drops are typically prescribed, applied 3-4 times daily for 5-7 days.
  • Viral conjunctivitis, which is more common, generally resolves on its own within 7-10 days without antibiotics.
  • For symptom relief in both types, apply a clean, warm compress to the affected eye(s) for 5-10 minutes, 3-4 times daily.
  • Gently wipe away discharge using a clean cotton ball moistened with warm water, wiping from the inner corner outward.
  • Keep your child's hands clean and discourage eye rubbing to prevent spread.
  • Use separate towels and washcloths for the affected child.

Allergic Conjunctivitis

  • For allergic conjunctivitis, pediatric-formulated antihistamine eye drops like ketotifen (Zaditor, Alaway) can provide relief.

Return to School or Daycare

  • Children can typically return to school or daycare 24 hours after starting antibiotic treatment for bacterial conjunctivitis.

When to Seek Medical Attention

  • Seek immediate medical attention if your child experiences severe eye pain, vision changes, or symptoms worsen despite treatment. These treatments work by either eliminating the bacterial infection, providing symptomatic relief for viral cases, or reducing the allergic response in allergic conjunctivitis, as supported by the recent study 1. Additionally, prevention of conjunctivitis is crucial, and measures such as proper hygiene, use of separate towels and washcloths, and avoidance of close contact with others during the period of contagion can help reduce the spread of the infection, as recommended in 1.

From the FDA Drug Label

In a randomized, double-masked, multicenter, parallel-group clinical trial of pediatric patients with bacterial conjunctivitis between birth and 31 days of age, patients were dosed with moxifloxacin ophthalmic solution or another anti-infective agent. Clinical outcomes for the trial demonstrated a clinical cure rate of 80% at Day 9 and a microbiological eradication success rate of 92% at Day 9

Moxifloxacin ophthalmic solution can be used to treat conjunctivitis in kids, with a clinical cure rate of 80% and a microbiological eradication success rate of 92% in pediatric patients with bacterial conjunctivitis between birth and 31 days of age 2.

From the Research

Conjunctivitis Treatment in Kids

  • Bacterial conjunctivitis is more common in children and typically presents as mucopurulent discharge with the eyelids matted shut 3.
  • Delayed antibiotic prescribing has been found to have similar symptom control as immediate prescribing for bacterial conjunctivitis 3.
  • Topical antibiotics decrease the duration of bacterial conjunctivitis and allow earlier return to school or work 4.
  • The majority of cases in bacterial conjunctivitis are self-limiting and no treatment is necessary in uncomplicated cases 4.
  • However, conjunctivitis caused by gonorrhea or chlamydia and conjunctivitis in contact lens wearers should be treated with antibiotics 4.
  • Treatment for viral conjunctivitis is supportive, including artificial tears, cold compresses, and antihistamine eye drops 3, 4.
  • Observation without treatment is strongly recommended for non-herpetic viral and bacterial infections 5.
  • Systemic and topical anti-viral was consistently recommended for herpetic viral conjunctivitis, while systemic and topical antibiotics were recommended for chlamydial and gonorrhoeal conjunctivitis 5.

Special Considerations

  • 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 3.
  • Strict personal hygiene, including frequent handwashing, is essential to decrease the risk of transmission 3.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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