Sandbox ID Eye

Conjunctivitis

• Conjunctivitis, acute

• Empiric antimicrobial therapy, bacterial

• Preferred regimen (1): Gentamicin ointment qid for 1 week OR Gentamicin solution 1-2 drops qid for 1 week OR Tobramycin ointment tid for 1 week
• Preferred regimen (2): Besifloxacin solution 1 drop 3 times for 1 week OR Ciprofloxacin ointment tid for 1 week OR Ciprofloxacin solution 1-2 drops topical qid for 1 week OR Gatifloxacin solution tid for 1 week OR Levofloxacin solution 1-2 drops qid for 1 week OR Moxifloxacin solution tid for 1 week OR Ofloxacin solution 1-2 drops qid for 1 week
• Preferred regimen (3): Azithromycin ointment bid for 2 days, then 1 drop qd for 5 days OR Erythromycin ointment qid for 1 week
• Preferred regimen (4): Sulfacetamide ointment qid and at bedtime for 1 week OR Sulfacetamide solution 1-2 drops q2-3h for 1 week
• Preferred regimen (5): Trimethoprim/Polymyxin B solution 1 or 2 drops qid for 1 week

Note: Topical steroids are not recommended for bacterial conjunctivitis.

• Culture-directed antimicrobial therapy

• Methicillin-resistant Staphylococcus aureus

• Preferred regimen: Fortified Vancomycin

• Chlamydia trachomatis

• Inclusion conjunctivitis

• Preferred regimen: Azithromycin 1 g PO qd
• Alternative regimen: Doxycycline 100 mg PO bid for 7 days

• Conjunctivitis secondary to trachoma

• Preferred regimen: Azithromycin 20 mg/kg PO for one single dose
• Alternative regimen (1): Tetracycline OR Erythromycin ointment for 6 weeks
• Alternative regimen (2): Tetracycline PO for 3 weeks OR Erythromycin PO for 3 weeks

• Neisseria gonorrhoeae

• Hyperacute bacterial conjunctivitis, adult

• Preferred regimen: Ceftriaxone 1 g IM once

Note: Dual therapy to cover Chlamydia is indicated.

• Herpes simplex virus

• Preferred regimen: Acyclovir 1 drop topical 9 times per day OR Acyclovir 400 mg PO 5 times per day for 7-10 days OR Valacyclovir 500 mg PO tid for 7-10 days

Note: Topical steroids should be avoided.

• Varicella zoster virus

• Preferred regimen: Acyclovir 800 mg PO 5 times per day for 7-10 days OR Famciclovir 500 mg PO tid for 7-10 days OR Valacyclovir 1000 mg PO tid for 7-10 days

Note: Treatment usually consists of a combination of oral antivirals and topical steroids.

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