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Conjunctivitis Medical Therapy   ▸  Bacterial Conjunctivitis   ▸  Newborn Conjunctivitis Gram-Negative   ▸  Gram-Negative Cocci in Pairs   ▸  Gram-Negative Coccobacilli   ▸  Gram-Negative Bacilli

Bacterial Conjunctivitis Preferred Regimen Non-gonococcal ▸ Ciprofloxacin 1–2 gtts q2h while awake x 1st 2 days, then q4–8h x 7 days OR ▸ Gatifloxacin 1–2 gtts q2h while awake x 1st 2 days, then q4–8h x 7 days OR ▸ Levofloxacin 1–2 gtts q2h while awake x 1st 2 days, then q4–8h x 7 days OR ▸ Moxifloxacin 1–2 gtts q2h while awake x 1st 2 days, then q4–8h x 7 days Gonococcal Adult dose ▸ Ciprofloxacin 1 gm IM/IV as 1 dose Pediatric dose ▸ Ciprofloxacin 25-50 mg/kg IV/IM (not to exceed 125 mg) as 1 dose Alternative Regimen (for non-gonococcal only) ▸ Polymyxin B + Trimethoprim 1–2 gtts q3–6h x 7–10 days OR ▸ Azithromycin 1%, 1 gtt bid x 2 days, then 1 gtt daily x 5 days Chlamydia Trachomatis Preferred Regimen ▸ Azithromycin 1 gm once or twice weekly Alternative Regimen ▸ Doxycycline 100 mg bid po x 7 days Newborn Conjunctivitis N. gonorrhoeae (after 2-5 days) ▸ Ceftriaxone 25-50 mg/kg IV x 1 dose (not to exceed 125 mg) C. trachomatis (after 3-10 days) ▸ Erythromycin base or ethyl succinate syrup 12.5 mg/kg q6h x 14 days OR ▸ Azithromycin suspension 20 mg/kg po q24h x 3 days H. simplex (after 2-16 days) † ▸ Acyclovir 60 mg/kg/day IV divided into 3 daily doses OR ▸ Trifluridine OR Vidarabine as a topical antiviral therapy † Systemic and CNS disease should be evaluated with PCR of CSF and serum and LFTs in any child with suspected HSV eye infection. Gram-Negative Cocci in Pairs Preferred Regimen ▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h Alternative Regimen ▸ Penicillin G 4 MU IV q4h OR ▸ Ampicillin 2 g IV q4h OR ▸ Chloramphenicol 1—1.5 g IV q6h OR ▸ Moxifloxacin 400 mg IV q24h OR ▸ Aztreonam 2 g IV q6—8h Gram-Negative Coccobacilli Preferred Regimen ▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h Alternative Regimen ▸ Chloramphenicol 1—1.5 g IV q6h OR ▸ Cefepime 2 g IV q8h OR ▸ Meropenem 2 g IV q8h OR ▸ Moxifloxacin 400 mg IV q24h Gram-Negative Bacilli Preferred Regimen ▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h Alternative Regimen ▸ Cefepime 2 g IV q8h OR ▸ Meropenem 2 g IV q8h OR ▸ Aztreonam 2 g IV q6—8h OR ▸ Moxifloxacin 400 mg IV q24h OR ▸ TMP/SMZ 5 mg/kg IV q6—12h (TMP component)