From the Guidelines
For an 11-year-old child with a corneal abrasion, Polytrim (polymyxin B-trimethoprim) ophthalmic solution is a suitable antibiotic choice, with a recommended dosage of 1 drop in the affected eye every 4 hours for 5-7 days. This regimen is generally effective and well-tolerated in children, as it combines two antibiotics that prevent bacterial protein synthesis and cell wall formation, effectively treating most common bacteria that cause corneal abrasions 1. When administering eye drops, it is essential to have the child lie down or tilt their head back, gently pull down the lower eyelid to create a small pocket, and place the drop in this pocket without touching the eye or eyelid with the dropper. After instillation, the child should keep their eyes closed for 1-2 minutes to allow proper absorption. It is crucial to monitor for improvement while using the antibiotic; if pain worsens, vision decreases, or symptoms don't improve within 48 hours, immediate medical attention should be sought as this could indicate a more serious infection or complication. The choice of Polytrim is also influenced by the increasing resistance of certain bacteria to topical fluoroquinolones, as noted from 2005 to 2015, making it a preferable option for treating corneal abrasions in children 1. Key considerations include:
- The importance of proper administration technique to ensure the antibiotic's effectiveness
- Monitoring for signs of improvement or potential complications
- The rationale behind choosing Polytrim over other antibiotic options, considering resistance patterns and efficacy in treating common bacterial causes of corneal abrasions.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Adults: In mild to moderate infections, instill one drop in the affected eye(s) every three hours (maximum of 6 doses per day) for a period of 7 to 10 days. Pediatric Use: Clinical studies have shown Trimethoprim and Polymyxin B Sulfate Ophthalmic Solution to be safe and effective for use in pediatric patients over two months of age. The dosage regimen is the same as for adults. For an 11-year-old child with a corneal abrasion, the recommended dosage of Polytrim (Trimethoprim and Polymyxin B Sulfate Ophthalmic Solution) is:
- 1 drop in the affected eye(s) every 3 hours
- Maximum of 6 doses per day
- For a period of 7 to 10 days 2
From the Research
Corneal Abrasion Antibiotics for Children
- The dosage and number of days for corneal abrasion antibiotics in children age 11 is not explicitly stated in the provided studies 3, 4, 5, 6, 7.
- However, the studies suggest that topical antibiotic prophylaxis may be used to prevent infection in corneal abrasions, but the evidence is limited and the certainty of the evidence is low to very low 3.
- One study compared chloramphenicol ocular ointment with fusidic acid ocular gels in patients with corneal abrasion, but the frequency of application was not clearly reported 3.
- Another study investigated the effect of a three-day course of either ocular ointment combinations of chloramphenicol-clotrimazole or chloramphenicol-placebo in patients with corneal abrasion, but the study did not provide specific data on the dosage and number of days for children age 11 3.
Polytrim
- Polytrim, a combination of polymyxin B and trimethoprim, has been shown to have antimicrobial activity against Pseudomonas aeruginosa and Staphylococcus aureus, two common causes of corneal infections 5, 6, 7.
- The combination of Polytrim and rifampin has been found to be effective against a large panel of clinically relevant P. aeruginosa strains and may represent a promising therapeutic for P. aeruginosa keratitis 5.
- However, the studies do not provide information on the dosage and number of days for Polytrim in children age 11 with corneal abrasion.