Version October 2024
| Dose (each affected eye) | |
| Empiric approach | |
| Erythromycin 5 mg/gram ophthalmic ointment (preferred in noncontact lens wearers) | 0.5 inch (1.25 cm) 4 times daily for 5 to 7 days |
| or | |
| Trimethoprim-polymyxin B 0.1%-10,000 units/mL ophthalmic drops (preferred in noncontact lens wearers) | 1 to 2 drops 4 times daily for 5 to 7 days |
| or | |
| Ofloxacin 0.3% ophthalmic drops (preferred agent in contact lens wearer)* | 1 to 2 drops 4 times daily for 5 to 7 days |
| or | |
| Ciprofloxacin 0.3% ophthalmic drops (preferred agent in contact lens wearer)* | 1 to 2 drops 4 times daily for 5 to 7 days |
| or | |
| Ciprofloxacin 0.3% ophthalmic ointment (preferred agent in contact lens wearers)* | 0.5 inch (1.25 cm) 2 or 3 times daily for 5 to 7 days |
| or | |
| Fusidic acid 1% ophthalmic suspension (alternative for noncontact lens wearers; available in many areas other than United States) | 1 drop 2 times daily for 7 days |
| Specific approach | |
| Bacterial conjunctivitis¶ | |
| Erythromycin 5 mg/gram ophthalmic ointment (preferred in noncontact lens wearers) | 0.5 inch (1.25 cm) 4 times daily for 5 to 7 days |
| or | |
| Trimethoprim-polymyxin B 0.1%-10,000 units/mL ophthalmic drops (preferred in noncontact lens wearers) | 1 to 2 drops 4 times daily for 5 to 7 days |
| or | |
| Bacitracin-polymyxin B 500 units-10,000 units/gram ophthalmic ointment (alternative in noncontact lens wearers) | 0.5 inch (1.25 cm) 4 to 6 times daily for 5 to 7 days |
| or | |
| Bacitracin 500 units/gram ophthalmic ointment (alternative in noncontact lens wearers) | 0.5 inch (1.25 cm) 4 to 6 times daily for 5 to 7 days |
| or | |
| Ofloxacin 0.3% (preferred agent in contact lens wearers)* | 1 to 2 drops 4 times daily for 5 to 7 days |
| or | |
| Ciprofloxacin 0.3% ophthalmic drops (preferred agent in contact lens wearer)* | 1 to 2 drops 4 times daily for 5 to 7 days |
| or | |
| Ciprofloxacin 0.3% ophthalmic ointment (preferred agent in contact lens wearers)* | 0.5 inch (1.25 cm) 2 or 3 times daily for 5 to 7 days |
| or | |
| Azithromycin 1% ophthalmic drops (alternative for noncontact lens wearers) | 1 drop 2 times daily for 2 days; then 1 drop daily for 5 days |
| or | |
| Fusidic acid 1% ophthalmic suspension (alternative for noncontact lens wearers; available in many areas other than United States) | 1 drop 2 times daily for 7 days |
| Viral conjunctivitisΔ | |
| Antihistamine/decongestant drops (OTC)◊ | 1 to 2 drops 4 times daily as needed for no more than 3 weeks |
| Allergic conjunctivitisΔ | |
| Antihistamine/decongestant drops (OTC)◊ | 1 to 2 drops 4 times daily as needed for no more than 2 weeks |
| or | |
| Antihistamine/mast cell stabilizer drops◊ | Generally, 1 to 2 drops 1 to 3 times daily (regimens vary by medication) |
| Non-specific conjunctivitis | |
| Eye lubricant drops (OTC)◊ | 1 to 2 drops up to 6 times daily as needed |
| and/or | |
| Eye lubricant ointment (OTC)◊ | 0.5 inch (1.25 cm) at bedtime or 4 times daily as needed |
This table is intended for use in conjunction with UpToDate content on conjunctivitis. Some clinical presentations warrant prompt urgent referral to an ophthalmologist; warning signs may include decreased visual acuity, photophobia, severe pain, worsening symptoms after 1 day, or no response within a few days (except viral conjunctivitis which may worsen for 3 to 5 days); refer to topic.
Dosage regimens listed may differ from manufacturer's recommendations.OTC: over-the-counter (available without a prescription in the United States).
* Patients should discontinue contact lens use until there is no discharge for 24 hours after completion of therapy; used lenses and lens case should be discarded. If there is any corneal opacity or suspicion of keratitis, the patient should be evaluated by an ophthalmologist. Other available ophthalmic fluoroquinolones include levofloxacin 1.5% and moxifloxacin 0.5% solutions.
¶ In some countries, topical chloramphenicol is an option.
Δ Eye lubricant drops and/or ointment may be beneficial for mild symptoms.
◊ OTC available ophthalmic solutions include:آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
