From the FDA Drug Label
In the treatment of superficial ocular infections, erythromycin ophthalmic ointment approximately 1 cm in length should be applied directly to the infected eye(s) up to six times daily, depending on the severity of the infection. A ribbon of ointment approximately 1 cm in length should be instilled into each lower conjunctival sac. APPLY TO THE INFECTED EYE(S) 4 TIMES A DAY FOR 7 DAYSAS DIRECTED.
The recommended dose of erythromycin eye ointment is:
- Approximately 1 cm in length applied directly to the infected eye(s) up to six times daily for treatment of superficial ocular infections 1
- Approximately 1 cm in length instilled into each lower conjunctival sac for prophylaxis of neonatal gonococcal or chlamydial ophthalmia 1
- 4 times a day for 7 days as directed for infected eyes 1
From the Research
The standard dose of erythromycin ophthalmic ointment is a 1 cm ribbon (approximately 0.5 inch) applied directly to the lower conjunctival sac of each eye. For newborns receiving prophylaxis against ophthalmia neonatorum, this is typically administered as a single application within 24 hours after birth. For treatment of bacterial conjunctivitis in children and adults, the ointment is usually applied 2-6 times daily for 5-7 days, depending on the severity of the infection. When applying, gently pull down the lower eyelid to create a small pocket, place the ribbon of ointment there, and close the eye for 1-2 minutes to allow distribution across the eye surface. Temporary blurring of vision is expected after application. Erythromycin works by inhibiting bacterial protein synthesis, preventing bacterial growth and reproduction. The ointment formulation provides longer contact time with the eye surface compared to drops, which can improve effectiveness for certain conditions. Some key points to consider when using erythromycin ophthalmic ointment include:
- The importance of proper application technique to ensure effective distribution of the medication across the eye surface 2
- The potential for antibiotic resistance, particularly in cases where erythromycin is used frequently or inappropriately 3
- The need for careful consideration of alternative treatments, such as bacteriophages or antimicrobial peptides, in cases where antibiotic resistance is a concern 4
- The importance of empiric antibiotic therapy in cases where the source of infection is unknown, and the need for broad-spectrum coverage to ensure effective treatment 5