From the Guidelines
Pediatric conjunctivitis treatment should be directed at the root cause, with a focus on symptom relief and prevention of complications, as indicated by the most recent guidelines 1.
Causes and Treatment
The treatment of conjunctivitis in children depends on the underlying cause, which can be bacterial, viral, or allergic.
- For bacterial conjunctivitis, antibiotic eye drops such as polymyxin B-trimethoprim (Polytrim), erythromycin ointment, or moxifloxacin (Vigamox) are typically prescribed, applied 1-2 drops in the affected eye(s) every 4-6 hours for 5-7 days 1.
- Viral conjunctivitis, which is more common, usually resolves on its own within 7-10 days without antibiotics, with treatment focusing on symptom relief with cool compresses and artificial tears as needed 1.
- For allergic conjunctivitis, antihistamine eye drops like ketotifen (Zaditor) or olopatadine (Pataday) can be used twice daily 1.
Prevention and Hygiene
Regardless of the cause, parents should clean the child's eyes gently with warm water and a clean cloth, wiping from inner to outer corner, using separate cloths for each eye to prevent cross-contamination 1.
- Children should avoid touching their eyes and should use separate towels and pillowcases.
- Hand hygiene is crucial, especially in cases of epidemic adenoviral conjunctivitis, where infected individuals should be counseled to wash hands frequently and avoid close contact with others during the period of contagion 1.
Monitoring and Follow-up
If symptoms worsen, vision changes occur, or the condition doesn't improve within 48-72 hours, medical reevaluation is necessary 1.
- Children should generally stay home from school or daycare until discharge resolves or after 24 hours of antibiotic treatment for bacterial cases.
- It is essential to note that indiscriminate use of topical antibiotics or corticosteroids should be avoided, as they can induce toxicity or worsen certain infections, such as adenoviral or HSV infections 1.
From the FDA Drug Label
In a randomized, double-masked, multicenter, parallel-group clinical trial of pediatric patients with bacterial conjunctivitis, between birth and 31 days of age, patients were dosed with Ciprofloxacin ophthalmic solution or another anti-infective agent. Clinical outcomes for the trial demonstrated a clinical cure rate of 80% at Day 9 and a microbiological eradication success rate of 85% at Day 9
- Pediatric treatment for conjunctivitis: Ciprofloxacin ophthalmic solution has been studied in pediatric patients with bacterial conjunctivitis, showing a clinical cure rate of 80% and a microbiological eradication success rate of 85% at Day 9 2.
- Alternative option: Erythromycin ophthalmic solution is also indicated for the treatment of superficial ocular infections involving the conjunctiva and/or cornea caused by organisms susceptible to erythromycin, but its effectiveness in pediatric patients with conjunctivitis is not specified in the provided label 3.
From the Research
Pediatric Treatment for Conjunctivitis
- The treatment for conjunctivitis in children depends on the cause, which can be infectious (bacterial or viral) or non-infectious (allergic) 4, 5.
- Bacterial conjunctivitis is commonly treated with topical antibiotics, which can shorten the duration of symptoms and reduce the risk of complications 4, 5, 6.
- Viral conjunctivitis typically does not require treatment, as it is usually self-limiting, and treatment is supportive 4, 5.
- Allergic conjunctivitis can be treated with topical antihistamines, mast cell stabilizers, or systemic antihistamines, and is often seasonal 4, 5.
Factors Influencing Treatment
- The use of topical antibiotics for bacterial conjunctivitis can reduce the duration of symptoms, prevent person-to-person transmission, and reduce the rate of reinfection 6.
- A study found that ophthalmic antibiotic prescribing for acute infectious conjunctivitis in children was high, and increased significantly during the COVID-19 pandemic 7.
- Factors associated with reduced odds of prescribing ophthalmic antibiotics included concurrent diagnosis with acute otitis media, later study year, and evaluation in family medicine or optometry/ophthalmology clinics 7.