Therapy of conjunctivitis

	Dose
Empiric approach
Erythromycin 5 mg/gram ophthalmic ointment	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	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
Specific approach
Bacterial conjunctivitis*
Erythromycin 5 mg/gram ophthalmic ointment	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	1 to 2 drops 4 times daily for 5 to 7 days
OR
Bacitracin-polymyxin B 500 units-10,000 units/gram ophthalmic ointment	0.5 inch (1.25 cm) 4 to 6 times daily for 5 to 7 days
OR
Bacitracin 500 units/gram ophthalmic ointment	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
Azithromycin 1% ophthalmic drops	1 drop twice a day for 2 days; then 1 drop daily for 5 days
Viral conjunctivitis
Antihistamine/decongestant drops (OTC)	1 to 2 drops 4 times daily as needed for no more than 3 weeks
Allergic conjunctivitis
Antihistamine/decongestant drops (OTC)	1 to 2 drops 4 times daily as needed for no more than 4 weeks
Mast cell stabilizer/antihistamine 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 every 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

OTC: over-the-counter (available without a prescription in the United States).
* In some countries, topical chloramphenicol is an option.

Courtesy of Deborah S. Jacobs, MD with additional data from: The Wills Eye Manual, Chapter 5, "Conjunctiva/Sclera/Iris/External Disease," 4th ed, Kunimoto DY, Kanitkar KD, and Makar MS, eds, Philadelphia, PA: Lippincott Williams & Wilkins, 2004.

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Therapy of conjunctivitis