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Treatment of bacterial conjunctivitis and keratitis
Medical expert of the article
Last reviewed: 19.10.2021
In acute conjunctivitis, presumably caused by dangerous pathogens ( gonococcus, Pseudomonas aeruginosa ), treatment is started immediately, without waiting for a laboratory confirmation of the diagnosis, since a delay of 1-2 days can lead to the development of the corneal ulcer up to its perforation. The eye of the child with conjunctivitis is not covered with a bandage to prevent the emergence of conditions favorable for the reproduction of bacteria.
With acute staphylococcal conjunctivitis, local antibacterial drugs are prescribed: picloxidine, fusidic acid, tobramycin, chloramphenicol 0.25% (with inefficiency 0.3% drop), ofloxacin, ciprofloxacin or lomefloxacin 3-4 times a day, eye ointment (tetracycline, erythromycin or ofloxacin) 2-3 times a day.
With gonococcal conjunctivitis (proven or suspected) in the first days of the disease, eyes are washed with a solution of benzylpenicillin (10,000 units / ml) 4 times per hour, 1% tetracycline or 0.5% erythromycin ointment is poured every hour, then the number of procedures is gradually reduced to 4 times per day. In severe cases - installation of 0.3% solution of ofloxacin, ciprofloxacin or lomefloxacin up to 6 times a day in the eyes. Intramuscular administration of benzylpenicillin is possible, with penicillin intolerance prescribe cephalosporins.
With conjunctivitis caused by Pseudomonas aeruginosa, the drugs of choice - antibiotics-aminoglycosides: tobramycin 0.3%, gentamicin 0.3%, the therapeutic effect increases when combined with quinolone antibiotics topically (ofloxacin, ciprofloxacin, lomefloxacin) in drops and ointments in the first 2 day for 6-8 times a day, then up to 3-4 times a day. When the infection spreads to the cornea - tobramycin, gentamicin parabulbar in injections.
Additional treatment of bacterial conjunctivitis: with edema and pronounced irritation of the conjunctiva, installations of antiallergic or anti-inflammatory drops (cromoglycic acid, olopatadine, ketotifen or diclofenac) are added 2 times a day. When the cornea is affected, stimulators of cornea regeneration (taurine, dexpanthenol, vitapos).