Bacterial Conjunctivitis Empiric Therapy

Updated: Apr 04, 2023
  • Author: Jean Deschênes, MD, FRCSC; Chief Editor: Michael Stuart Bronze, MD  more...
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Empiric Therapy Regimens

Bacterial conjunctivitis is a microbial infection involving the mucous membrane of the surface of the eye. It is less common than viral conjunctivitis. The source of bacterial conjunctivitis can be endogenous or exogenous. It can have a slow, acute, or hyperacute onset. Depending on the pathogen, bacterial conjunctivitis may be a benign self-limited illness (most cases), may be sight-threatening, or may signify a severe underlying systemic disease. In patients with chronic unilateral bacterial conjunctivitis, the ipsilateral nasolacrimal system should be examined to rule out canaliculitis, nasolacrimal duct obstruction, or dacryocystitis. [1]

General and empiric therapeutic recommendations for acute bacterial conjunctivitis are provided below. [2] This review does not cover the treatment of hyperacute conjunctivitis, neonatal conjunctivitis, or trachoma.

General recommendations in the treatment of bacterial conjunctivitis

Eye drops have the advantage of not interfering with vision; ointments have the advantage of prolonged contact with the ocular surface and an accompanying soothing effect.

Most practitioners prescribe a broad-spectrum agent on an empiric basis without culture for a routine mild to moderate case of bacterial conjunctivitis. [2]

Treatment recommendations for acute non-severe bacterial conjunctivitis

Regimens for acute nonsevere bacterial conjunctivitis are as follows:

In conjunctivitis otitis syndrome, Haemophilus conjunctivitis in children, or conjunctivitis associated with a pharyngitis, a supplemental oral antibiotic should be considered.