Template:Bacterial Conjunctivitis Antibiotics

Treatment for bacterial organisms is targeted toward S. aureus, S. pneumoniae, H. influenzae, Pseudomonas, N. gonorrhea, C. trachomatis
Contact lens wearers should be given coverage for pseudomonas with one of the fluoroquinolone drops

Counsel patient/family on importance of hand hygiene/avoiding touching face to prevent spread!

These options do not cover gonococcal or chlamydial infections

Polymyxin B/Trimethoprim (Polytrim) 2 drops every 6 hours for 7 days OR
Erythromycin applied to the conjunctiva q6hrs for 7 days OR
Levofloxacin 0.5% ophthalmic solution 1-2 drops every 2 hours for 2 days THEN every 6 hours for 5 days OR
Moxifloxacin 0.5% ophthalmic 1-2 drops every 2 hours for 2 days THEN every 6 hours for 5 days OR
Gatifloxacin 0.5% ophthalmic solution 1-2 drops every 2 hours for 2 days THEN 1 drop every 6 hours for 5 days OR
Azithromycin 1% ophthalmic solution 1 drop BID for 2 days THEN 1 drop daily for 5 days

NB: levofloxacin is preferred for contact lens wearers for coverage of pseudomonas. Advise not to wear contacts for duration of treatment

Doxycycline 100mg PO BID for 7 days OR
Azithromycin 1g (20mg/kg) PO one time dose
Newborn Treatment: Azithromycin 20mg/kg PO once daily x 3 days
- Disease manifests 5 days post-birth to 2 weeks (late onset)

Due to increasing resistance, CDC recommends dual therapy with Ceftriaxone and Azithromycin (even if patient is negative for Chlamydia).
Ceftriaxone 250mg IM one dose PLUS
Azithromycin 1g PO one dose
Newborn Treatment:
- Prophylaxis: Erythromycin ophthalmic 0.5% x1
- Disease manifests 1st 5 days post delivery (early onset)
- Treatment Ceftriaxone 25-50mg IV or IM, max 125mg