Outcome Evaluation

Significant improvement of acute bacterial conjunctivitis should be seen within 1 week.11 Terminate treatment with topical antibiotics when the inflammation is resolved.12

Table 63-2 Adult Bacterial Conjunctivitis Dosing Guidelines for Topical Ophthalmic Antibiotics

Azithromycin 1% solution

Ciprofloxacin 3.5 mg/mL solution

Ciprofloxacin 0.3% ointment

Erythromycin 0.5% ointment Gatifloxacin 0.3% solution

Gentamicin 0.3% solution

Levofloxacin 0.5% solution

Days I and 2:1 drop twice daily,

8-12 hours apart Days 3-7:1 drop once daily Days 1 and 2:1-2 drops every 2

hours while awake Days 3-7:1-2 drops every 4 hours while awake Apply a Vi in. ribbon of ointment 3 times daily for 2 days, then twice daily for next 5 days Apply a 16 in. ribbon of ointment up to 6 times daily Days 1 and 2: 1 drop every 2 hours while awake up to 8 times daily Days 3-7:1 drop every 4 hours while awake 1-2 drops every 4 hours. In severe infections, may use up to 2 drops every hour Days I and 2:1-2 drops every 2 hours while awake, up to 8 times per day Days 3-7:1-2 drops every 4 hours while awake, up to 4 times daily

Moxifloxacin 0.5% solution Ofloxacin 0.3% Solution

Polymyxin I? vvirh bacitracin ointment Polymyxin B/ttimethoprin i solutbn Sulfacetamide 10% ointment

Sulfa cetamide boiution

Tobramycin 0.3% ointment

Tobi.irnycin 0.3% solution

1 drop 3 times a day for 7 days Days I and 2:1-2 drops every 2-4

hours while awake Days 3-7:1-2 drops 4 times daily Appty a % in. ribbon of ointment every 3-4 hours for 7-10 days 1 drop every 3 hours lor 7-10 days

Apply a V) in. ribbon of ointment every 3-4 hours and at bedtime \ -2 drops every 2 3 hours for

7-10 days Mi Id-to-mo derate infections: Apply a Vi in, ribbon of ointment 7-3 times daily Severe infections: Apply every 3-4 hours

Mifd-to-moderate infections: 1 -2

drops every A hours Severe infections: initially; 2 drops every hour

VIRAL CONJUNCTIVITIS Etiology

The most common cause of viral conjunctivitis is adenovirus. It is often called "pinkeye."10 Viral conjunctivitis infections are easily spread through swimming pools, camps, and contaminated fingers, and medical instruments.14 Patients often present with an upper respiratory tract infection or recent exposure to viral conjunctivitis.

While the infection begins in one eye, it will spread to both eyes 50% of the time.

Viral conjunctivitis is usually self-limiting, worsening after 4 to 7 days but then resolving within 2 to 4 weeks. 10 Five percentage of patients remain contagious 16 days after the appearance of symptoms.11

Table 63-3 Pediatric Dosing Guidelines for Bacterial Conjunctivitis for Topical Ophthalmic Antibiotics

Azithromycin 1% solution

Ciprofloxacin 3.5 mg/mt solution

Ciprofloxacin 0.3% ointment

Erythromycin 0.5% ointment Gatifloxacin 0.3% solution

Gentamicin 0.3% solution

Levofloxacin 0.5% solution

Children I year of age or older: Days I and 2: I drop twice daily, 8-12 hours apart

Days 3-7: I drcp once daily Children 1 year of age or older, days 1 and 2:1-2 drops every 2 hours while awake

Days 3-7:1-2 drops every 4 hours while awake

Children 2 years of age or older: Apply a V* in. ribbon of ointment 3 times daily for 2 days, then twice daily for next 5 days

Apply a Vi in. ribbon of ointment up to 6

times daily Children 1 year of age or older, days 1 and 2:1 drop every 2 hours while awake up to 3 times daily Days 3-7:1 drcp every 4 hours while awake

Infants and children 28 days of age or older: 1-2 drops every 4 hours. In severe infectons, may use up to 2 drops every hour Children 1 year of age or older, days 1 and 2:1-2 drops every 2 hours while awake, up to 8 times daily Days 3-7:1-2 drops every 4 hours while awake, up to 4 times daily

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