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