From the FDA Drug Label
Instill one drop in the affected eye 3 times a day for 7 days. For moxifloxacin (OPHTH), the topical length of treatment for lacrimal stones is 7 days 1. For gatifloxacin (OPHTH), the topical length of treatment is also 7 days, but with varying frequencies of administration 2.
- Day 1: every 2 hours, up to 8 times
- Days 2-7: 2-4 times daily The recommended treatment duration for both antibiotics is 7 days.
From the Research
Topical antibiotic treatment for lacrimal stones typically involves a 5-day course of antibiotic eye drops, such as moxifloxacin 0.5%, administered 3 times daily, as this regimen has been shown to be effective in treating bacterial conjunctivitis and reducing the risk of treatment failures 3. The choice of antibiotic and duration of treatment should be based on the severity of the infection and the suspected causative organism.
- For patients with suspected gram-positive infections, erythromycin 0.5% ointment applied 2-3 times daily may be used.
- The treatment duration should be completed even if symptoms improve earlier to ensure complete resolution of any infection.
- These antibiotics help reduce inflammation and treat any secondary infection associated with the stones, though they do not dissolve the stones themselves.
- Patients should be advised that while antibiotics address infection, mechanical removal of the stones may still be necessary through irrigation, probing, or in some cases surgical intervention if symptoms persist.
- Warm compresses applied to the affected area for 5-10 minutes several times daily can complement antibiotic therapy by improving drainage and reducing inflammation.
- If symptoms worsen or fail to improve after 48-72 hours of treatment, patients should seek follow-up care promptly. The use of topical moxifloxacin has been shown to be cost-effective and can generate total healthcare budget savings by reducing both the costs of managing treatment failures and the use of clinicians' time to manage such failures 3.
- Moxifloxacin has a broad spectrum of antibacterial activity, including activity against penicillin-resistant Streptococcus pneumoniae, and achieves good tissue penetration 4.
- The fourth-generation fluoroquinolones, including moxifloxacin, have improved potency and are able to overcome resistant isolates, making them a good option for the treatment of ocular infections 5.