From the Guidelines
For an 11-year-old child with a corneal abrasion, topical antibiotic eye drops such as erythromycin 0.5% ointment or fluoroquinolone drops like moxifloxacin 0.5% should be prescribed for 5-7 days to prevent infection. The dosage is typically one drop in the affected eye or a small ribbon of ointment (about 1/4 inch) placed inside the lower eyelid, applied 3-4 times daily for erythromycin or 4 times daily for fluoroquinolones 1. It's crucial to note that the use of fluoroquinolones should be done with awareness of the increased resistance of certain bacteria like MRSA and Pseudomonas aeruginosa 1.
Key Considerations
- The treatment duration is usually until the abrasion has completely healed, which can take 5-7 days.
- Parents should be advised to ensure their child doesn't rub the eye and to follow up with an eye care provider if symptoms worsen or don't improve within 48 hours.
- Pain management with oral acetaminophen or ibuprofen at age-appropriate doses may also be necessary, and artificial tears can provide additional comfort.
- It's also important to avoid patching the eye, especially in patients who wear contact lenses, due to the increased risk of bacterial keratitis 1.
Additional Recommendations
- The use of a cycloplegic agent may be considered as an adjunctive treatment to decrease pain and synechia formation in cases of substantial anterior chamber inflammation 1.
- Corticosteroids may be considered after 24 to 48 hours when the causative organism is identified and/or infection is responding to therapy, but should be avoided in cases of infection involving certain organisms like Acanthamoeba, Nocardia, and fungus 1.
From the Research
Corneal Abrasion Antibiotics for Children
- The dosage and number of days for antibiotic treatment of corneal abrasion in children age 11 is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
- However, one study compared the effect of a three-day course of either ocular ointment combinations of chloramphenicol-clotrimazole or chloramphenicol-placebo in patients with corneal abrasion, with all three times daily dosage 2.
- Another study discussed the acute management of corneal abrasion, including the use of antibiotic and tetanus prophylaxis, but did not specify the dosage or duration for children age 11 3.
- A study on the evaluation and management of corneal abrasions suggested that topical antibiotics are commonly prescribed to prevent bacterial superinfection, but did not provide specific guidance on dosage or duration for children age 11 5.
Treatment Considerations
- The goals of treatment for corneal abrasion include pain control, prevention of infection, and healing 5.
- Topical nonsteroidal anti-inflammatory drugs or oral analgesics may be used for pain relief, and topical antibiotics may be prescribed to prevent bacterial superinfection 5.
- Contact lens-related abrasions should be treated with antipseudomonal topical antibiotics 5.
- Follow-up may not be necessary for patients with small, uncomplicated abrasions, normal vision, and resolving symptoms, but all other patients should be reevaluated in 24 hours 5.