What is the treatment for pediatric conjunctivitis?

From the Guidelines

Pediatric conjunctivitis treatment should be directed at the root cause, with early detection and treatment being crucial to prevent complications and promote optimal outcomes, as emphasized in the most recent guidelines 1. When it comes to treating pediatric conjunctivitis, the approach varies depending on the underlying cause. For bacterial conjunctivitis, topical antibiotic eye drops or ointments are recommended. Some options include:

• Erythromycin 0.5% ointment applied 4 times daily for 5-7 days
• Polymyxin B-trimethoprim drops used 4 times daily for 7-10 days
• Fluoroquinolones like moxifloxacin 0.5% drops for severe cases, used 3 times daily for 7 days Viral conjunctivitis, on the other hand, is typically self-limiting and requires supportive care with:
• Artificial tears
• Cool compresses For allergic conjunctivitis, antihistamine drops can provide relief, such as:
• Ketotifen 0.025% twice daily
• Olopatadine 0.1% twice daily It's essential for parents to be instructed on proper eye care to prevent cross-contamination, including:
• Cleaning the child's eyes with warm water and a clean cloth
• Using separate towels
• Washing hands frequently Children should avoid touching their eyes and stay home from school or daycare until discharge resolves or after 24 hours of antibiotic treatment for bacterial cases, as highlighted in previous guidelines 1.

From the FDA Drug Label

For the treatment of superficial ocular infections involving the conjunctiva and/or cornea caused by organisms susceptible to erythromycin. Gentamicin sulfate ophthalmic solution, USP is indicated in the topical treatment of ocular bacterial infections including conjunctivitis, keratitis, keratoconjunctivitis, corneal ulcers, blepharitis, blepharoconjunctivitis, acute meibomianitis, and dacryocystitis, caused by susceptible strains of the following microorganisms:

• Erythromycin can be used for the treatment of superficial ocular infections involving the conjunctiva and/or cornea caused by organisms susceptible to erythromycin 2.
• Gentamicin is indicated for the topical treatment of ocular bacterial infections including conjunctivitis caused by susceptible strains of certain microorganisms 3. For pediatric conjunctivitis treatment, erythromycin and gentamicin can be considered, but the specific dosage and administration should be based on the severity of the infection and the patient's condition, as described in the dosage and administration section of the drug label 2.

From the Research

Pediatric Conjunctivitis Treatment

• The treatment for pediatric conjunctivitis varies depending on the cause, which can be infectious (bacterial or viral) or non-infectious (allergic) 4.
• Bacterial conjunctivitis is typically treated with supportive care, and antibiotics may be used to shorten symptom duration, but their use is not without risks 4, 5.
• Viral conjunctivitis is usually treated with supportive care, as it often resolves on its own, and treatment is focused on alleviating symptoms 4, 5, 6.
• Allergic conjunctivitis is treated with topical lubricants, topical antihistamine agents, or systemic antihistamines, and management may include non-pharmacological treatments and avoidance measures 4, 7, 5, 6.

Specific Treatment Approaches

• For bacterial conjunctivitis, topical antibiotics can decrease the duration of the infection and allow for an earlier return to school or work 5.
• In cases of allergic conjunctivitis, treatment with antihistamines and mast cell stabilizers can alleviate symptoms 7, 5, 6.
• For viral conjunctivitis, supportive care options include artificial tears, cold compresses, and antihistamine eye drops 6.
• In severe cases of allergic conjunctivitis, short-lasting local steroid therapy or cyclosporine may be used as a disease-modifying treatment 7.

Considerations for Specific Patient Groups

• Neonatal conjunctivitis requires special care due to unique pathogens and considerations 4.
• Contact lens wearers should always be treated for bacterial conjunctivitis and referred for evaluation for corneal ulcers 4.
• Patients with a history of rheumatologic disease, immunocompromised state, or recent ocular surgery may require ophthalmology referral 6.