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Topical Eye Antibiotic

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Topical Eye Antibiotic, Ophthalmic Antibiotic

  • Indications
  1. Treatment of infection
    1. Bacterial Conjunctivitis
  2. Prophylaxis in Eye Injury (avoid Aminoglycosides due to toxicity risk)
    1. Corneal Abrasion
    2. Chemical Eye Burn
  • Medications
  • Most cost effective agents
  1. First-line
    1. Trimethoprim-Polymyxin B (Polytrim) solution 1 drop four times daily
    2. Erythromycin 0.5% ointment nightly (or every 6 hours as single agent) for 7 days
  2. Broad-spectrum
    1. Gentamicin (Gentak) 0.3% ointment 0.5 inch every 6 hours for 7 days
    2. Gentamicin (Gentak) 0.3% solution 1 drop every 4 hours for 7 days
    3. Tobramycin (Tobrex) 0.3% solution (ointment is not generic and is expensive)
    4. Ciprofloxacin (Ciloxan) 0.3% ointment 0.5 inch every 8 hours for 2 days, then every 12 hours for 5 days
    5. Ciprofloxacin (Ciloxan) 0.3% solution 1 drop every 2 hours for 2 days, then every 4 hours while awake for 5 days
    6. Ofloxacin (Ocuflox) 0.3% solution 1 drop every 2 hours for 2 days, then every 6 hours while awake for 5 days
    7. Levofloxacin (Quixin) 0.5% solution 1 drop every 2 hours for 2 days, then every 4 hours while awake for 5 days
    8. Moxifloxacin (Vigamox) 0.5% solution 1 drop every 8 hours for 7 days
  • Medications
  • First-Line general purpose
  1. Trimethoprim-Polymyxin B (Polytrim) solution 1 drop four times daily
  2. Sulfacetamide 10% (Bleph-10) ointment or Solution
    1. Typically avoid due to low efficacy and reaction risk
  3. Bacitracin ointment (used in stye)
  1. Erythromycin 0.5% ointment nightly (or every 6 hours as single agent) for 7 days
  2. Azithromycin 1% (Azasite) solution 1 drop every 12 hours for 2 days, then 1 drop daily for 5 days
  1. Precautions
    1. Reserve for severe infections to prevent resistance
  2. Ciprofloxacin (Ciloxan) 0.3% ointment 0.5 inch every 8 hours for 2 days, then every 12 hours for 5 days
  3. Ciprofloxacin (Ciloxan) 0.3% solution 1 drop every 2 hours for 2 days, then every 4 hours while awake for 5 days
  4. Ofloxacin (Ocuflox) 0.3% solution 1 drop every 2 hours for 2 days, then every 6 hours while awake for 5 days
  5. Levofloxacin (Quixin) 0.5% solution 1 drop every 2 hours for 2 days, then every 4 hours while awake for 5 days
  6. Moxifloxacin (Vigamox) 0.5% solution 1 drop every 8 hours for 7 days
  7. Besifloxacin (Besivance) 0.6% solution
  8. Gatifloxacin (Zymar) 0.3%
  1. Precautions
    1. Reserve for severe infections to prevent resistance
    2. Avoid if Corneal Injury (toxicity risk)
  2. Gentamicin (Gentak) 0.3% ointment 0.5 inch every 6 hours for 7 days
  3. Gentamicin (Gentak) 0.3% solution 1 drop every 4 hours for 7 days
  4. Tobramycin (Tobrex) 0.3% solution (ointment is not generic and is expensive)
  • Medications
  • To Avoid
  1. Neomycin (topical reactions are common)
  • References
  1. Cronau (2010) Am Fam Physician 81(2): 137-45 [PubMed]