Polytrim Eye Drops Age Recommendation
Polytrim (polymyxin B sulfate/trimethoprim) ophthalmic solution can be safely initiated in pediatric patients over 2 months of age. 1
FDA-Approved Age Guidelines
The FDA drug label explicitly states that clinical studies have demonstrated Polytrim to be safe and effective for use in pediatric patients over 2 months of age, with the same dosage regimen as adults (one drop in affected eye(s) every 3 hours, maximum 6 doses daily for 7-10 days). 1
Supporting Clinical Evidence
Safety profile in young children: A large patient outcomes study of 472 children with acute bacterial conjunctivitis treated with trimethoprim-polymyxin B demonstrated excellent safety, with only 4 transient mild-to-moderate adverse events reported and 95% of infected eyes cured or improved within 7 days. 2
Efficacy across pediatric age groups: Multiple randomized controlled trials have confirmed the effectiveness of Polytrim in children ages 1-18 years, with clinical cure rates of 96% by day 7-10 and comparable efficacy to newer fluoroquinolones like moxifloxacin. 3
Critical Safety Consideration
Do not use Polytrim in infants under 2 months of age. This contraindication exists because the trimethoprim component (similar to trimethoprim-sulfamethoxazole systemic formulations) poses a theoretical risk of kernicterus in very young infants due to displacement of bilirubin from albumin binding sites. 4, 1
Practical Dosing for Pediatric Patients
- Instill 1 drop in the affected eye(s) every 3 hours while awake (maximum 6 doses per day) 1
- Continue treatment for 7-10 days even if symptoms improve earlier 1
- The pediatric dosing regimen is identical to adult dosing—no weight-based adjustments are needed 1
Common Clinical Pitfall
While Polytrim has broad-spectrum coverage against common conjunctivitis pathogens (Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis), it has poor activity against beta-hemolytic streptococci. 5 However, this limitation is not clinically significant for typical bacterial conjunctivitis in children, where the medication demonstrates 95-96% cure rates. 2, 3