Management of Bacterial conjunctivitis
Pathogens: H. infl uenzae, S. pneumoniae, S. aureus, N. gonorrhoea.
Features
• Gritty red eye
• Purulent, lids stuck in morning
• Starts in one eye, spreads to other
• Usually bilateral purulent discharge
• Negative fl uorescein staining
Swab for smear and culture for:
• hyperacute or severe purulent conjunctivitis
• prolonged infection
• neonates
Management (mild cases) Limit the spread by avoiding close contact with
others, use of separate towels and good ocular hygiene.
Mild cases may resolve with saline irrigation of the eyelids and conjunctiva
but may last up to 14 days if untreated. An antiseptic eye drop such
as propamidine isethionate 0.1% (Brolene) 1–2 drops 6–8 times hrly for
5–7 d can be used.
Management (more severe cases)
• chloramphenicol 0.5% eye drops 1–2 hrly for 2 d, decrease to qid for
7 d ± chloramphenicol 1% eye ointment nocte or
• polymyxin B sulphate 5000 U, neomycin 2.5 mg, gramicidin 25 mcg
per mL, (Neosporin) eye drops 1–2 drops hrly, decreasing to 6 hrly as
infection improves ± Neosporin eye ointment at night
Specifi c organisms:
• Pseudomonas and other coliforms: use topical gentamicin and
tobramycin
• Neisseria gonorrhoea: use appropriate systemic antibiotics
• Chlamydia trachomatis: brick red follicular conjunctivitis, use oral
azithromycin
Pathogens: H. infl uenzae, S. pneumoniae, S. aureus, N. gonorrhoea.
Features
• Gritty red eye
• Purulent, lids stuck in morning
• Starts in one eye, spreads to other
• Usually bilateral purulent discharge
• Negative fl uorescein staining
Swab for smear and culture for:
• hyperacute or severe purulent conjunctivitis
• prolonged infection
• neonates
Management (mild cases) Limit the spread by avoiding close contact with
others, use of separate towels and good ocular hygiene.
Mild cases may resolve with saline irrigation of the eyelids and conjunctiva
but may last up to 14 days if untreated. An antiseptic eye drop such
as propamidine isethionate 0.1% (Brolene) 1–2 drops 6–8 times hrly for
5–7 d can be used.
Management (more severe cases)
• chloramphenicol 0.5% eye drops 1–2 hrly for 2 d, decrease to qid for
7 d ± chloramphenicol 1% eye ointment nocte or
• polymyxin B sulphate 5000 U, neomycin 2.5 mg, gramicidin 25 mcg
per mL, (Neosporin) eye drops 1–2 drops hrly, decreasing to 6 hrly as
infection improves ± Neosporin eye ointment at night
Specifi c organisms:
• Pseudomonas and other coliforms: use topical gentamicin and
tobramycin
• Neisseria gonorrhoea: use appropriate systemic antibiotics
• Chlamydia trachomatis: brick red follicular conjunctivitis, use oral
azithromycin