From the Guidelines
For children with corneal abrasions, chloramphenicol ointment 1% is recommended, applied three times a day for 3 days, as evidenced by the Bhaktapur Eye Study 1. This treatment regimen has been shown to be effective in preventing corneal ulcers and reducing the risk of bacterial keratitis. The use of chloramphenicol ointment is a cost-effective method for preventing the morbidity and further healthcare costs associated with bacterial keratitis, especially in low- to middle-income countries 1. Key points to consider when treating corneal abrasions in children include:
- Applying chloramphenicol ointment 1% three times a day for 3 days
- Ensuring the child avoids eye rubbing and uses lubricating eye drops to reduce discomfort
- Considering oral acetaminophen or ibuprofen for pain management at age-appropriate doses
- Scheduling prompt ophthalmology follow-up if the abrasion is large or central, or if symptoms worsen despite treatment
- Discontinuing contact lens use until the abrasion is completely healed and cleared by a healthcare provider. The estimated cost of medication for treating bacterial keratitis can be significant, with an estimated wholesale cost of $933 USD per patient in the United States 1, highlighting the importance of effective prevention and treatment strategies.
From the FDA Drug Label
For conjunctivitis and other superficial ocular infections: Instill one or two drops into the conjunctival sac(s) of the affected eye(s) every two to three hours initially. Dosages may be tapered by increasing the time interval between doses as the condition responds. The usual duration of treatment is seven to ten days.
The recommended dosage for children with corneal abrasion is one or two drops of sulfacetamide (TOP) into the conjunctival sac(s) of the affected eye(s) every two to three hours. The treatment should last for seven to ten days 2.
From the Research
Corneal Abrasion Antibiotics for Children
- The dosage and number of days for antibiotic treatment of corneal abrasion in children is not clearly specified in the provided studies 3, 4, 5, 6, 7.
- A study from 2022 compared chloramphenicol ocular ointment with fusidic acid ocular gels in participants older than 5 years of age with corneal abrasion, but the frequency of application was not clearly reported 3.
- Another study from 2022 investigated the effect of a three-day course of either ocular ointment combinations of chloramphenicol-clotrimazole or chloramphenicol-placebo, all three times daily, in participants older than 5 years of age with corneal abrasion 3.
- The use of topical antibiotics, such as chloramphenicol or antipseudomonal antibiotics, is commonly prescribed to prevent bacterial superinfection in corneal abrasions, but the evidence is lacking 4, 5.
- The treatment of corneal abrasions should focus on pain control, prevention of infection, and healing, and may include the use of topical nonsteroidal anti-inflammatory drugs or oral analgesics 4, 5, 6, 7.
Antibiotic Regimens
- Chloramphenicol ocular ointment and fusidic acid ocular gels have been compared in a study, but the results did not show a significant difference in terms of infection or healing 3.
- A combination of chloramphenicol-clotrimazole or chloramphenicol-placebo has been investigated, but the evidence is limited and the results did not show a significant difference in terms of infection or healing 3.
- Antipseudomonal topical antibiotics are recommended for contact lens-related abrasions 5.
Duration of Treatment
- A three-day course of antibiotic treatment has been investigated in a study, but the evidence is limited and the results did not show a significant difference in terms of infection or healing 3.
- The duration of treatment for corneal abrasions is not clearly specified in the provided studies, and further research is needed to determine the optimal duration of treatment 3, 4, 5, 6, 7.