From the Guidelines
Antibiotics such as azithromycin eye drops can effectively treat both blepharitis and bacterial conjunctivitis, as they inhibit bacterial protein synthesis or DNA replication, preventing bacterial growth 1.
Treatment Approach
When treating both blepharitis and bacterial conjunctivitis, it is essential to consider a comprehensive approach that includes medication and supportive care.
- For blepharitis, applying azithromycin drops once daily for 2-3 days or erythromycin ointment to the eyelid margins twice daily for 7-10 days can be effective 1.
- For bacterial conjunctivitis, the same medications can be applied directly into the conjunctival sac 3-4 times daily for erythromycin or twice daily for azithromycin, typically for 5-7 days 1.
Supportive Care
In addition to antibiotics, warm compresses and gentle eyelid cleansing with diluted baby shampoo or commercial eyelid cleansers are crucial for blepharitis management 1.
- Warm compresses can be applied to the eyelids for several minutes to soften adherent scurf and scales or discharge and/or warm the meibomian secretions.
- Eyelid cleansing can be accomplished by brief, gentle massage of the eyelids, and eye cleaners with hypochlorous acid at 0.01% have a strong antimicrobial effect.
Monitoring and Follow-up
If symptoms do not improve within a week, or if you experience vision changes, increased pain, or worsening redness, it is essential to consult an eye care professional as you may need different treatment 1.
From the Research
Medications for Blepharitis and Bacterial Conjunctivitis
- The following medications can be used to treat both blepharitis and bacterial conjunctivitis:
- Topical antibiotics such as chloramphenicol, bacitracin/polymyxin B, ofloxacin, sulfa, ciprofloxacin, trimethoprim/polymyxin B, norfloxacin, gentamicin, bacitracin, trimethoprim, tobramycin, neomycin, erythromycin, and polymyxin B 2
- Ciprofloxacin has been shown to be effective in treating blepharitis and blepharoconjunctivitis, with a bacteriological cure rate of 93.7% 3
- It's worth noting that the choice of medication should be based on clinical experience, ongoing critical evaluation of available antibiotics, and cost-effectiveness, as no single antibiotic provides 100% broad-spectrum coverage in vitro 2
Treatment Considerations
- Bacterial conjunctivitis can be treated empirically with topical antibiotics, but gonococcal and chlamydial conjunctivitis require systemic antibiotics 4, 5
- Topical antibiotics can decrease the duration of bacterial conjunctivitis and allow for an earlier return to school or work 5
- In some cases, such as conjunctivitis caused by gonorrhea or chlamydia, or in contact lens wearers, antibiotic treatment is necessary 5, 6