Sandbox ID Eye

Conjunctivitis

• Conjunctivitis, acute bacterial

• Empiric antimicrobial therapy

• Preferred regimen: Gentamicin ointment qid for 1 week OR Gentamicin solution 1-2 drops qid for 1 week OR Tobramycin ointment tid for 1 week
• Alternative regimen (1): Besifloxacin 1 drop 3 times for 1 week OR Ciprofloxacin Ointment: 3times per day for 1week OR Ciprofloxacin Solution: 1-2drops 4times per day for 1week OR Gatifloxacin: 3times per day for 1week OR Levofloxacin:1-2drops 4times per day for 1week OR Moxifloxacin : 3times per day for 1week OR Ofloxacin:1-2drops 4times per day for 1week.
• Alternative regimen (2): Azithromycin:2times per day for 2days ;then 1drop daily for 5days OR Erythromycin:4times per day for 1week
• Alternative regimen (3): Sulfacetamide ointment:4times per day and at bedtime for 1week
• Alternative regimen (4): Trimethoprim/Polymyxin B: 1 or 2 drops 4times per day for 1week.

• Culture-directed antimicrobial therapy

• Methicillin-resistant Staphylococcus aureus

• Preferred regimen: Fortified Vancomycin

• Chlamydia trachomatis

• Inclusion conjunctivitis

• Preferred regimen: Azithromycin 1gram :orally once
• Alternative regimen: Doxycycline100mg: orally 2 times per day for 7days

• 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.

• Allergic Conjuctivitis:

• Preferred regimen:

• Topical Antihistamines : Azelastine : 0.05% 1drop 2times perdayOR Emedastine : 0.05% 1drop 4times per day
• [Topical Mast cell inhibitors]] :Cromolyn sodium 4%: 1-2drops every 4-6hours OR Lodoxamine 0.1% :1-2drops 4times per dayOR Nedocromil 2% : 1-2drops twice per day

• Alternate regimen:

• NSAIDS: Ketorolac:1 drop 4times per day OR Antihistamines / Vasoconstrictors OR Naphazoline/Phenramine:1-2drops upto 4times per day
• Combination drops: Ketotifen0.025% : 1 drop 2-3 per day OR Olopatadine 0.1% :1 drop twice per day

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