Organisms S aureus S epidermidis Conjunctivitis Adult and Children Notes

1. Sulfacetamide may sting or burn when applied. This often decreases compliance.

2. Ophthalmic ointment is thick and impairs vision when first applied. Although drops require more frequent dosing, patients usually tolerate drops better while awake. Ointment is best used at bedtime.

3. If conjunctivitis is secondary to an imbedded organic material (mascara brush, tree branch), or in contact lens wearers, consider antipseudomonal coverage.

4. Slit lamp exam important to rule out herpes as organism. If herpes or gonococcus suspected, immediate ophthalmologic consultation is indicated.

1. Erythromycin ophthalmic ointment (Ilotycin)—apply to lid of affected eye bid-tid [B]; dispense 3.5 g tube

2. Sulfacetamide (10%) ophthalmic solution or ointment (Bleph-10, Sodium Sulamyd) [C] Solution: apply 1-2 drops to affected eye q2h; dispense 5 mL

Ointment: apply to lid of affected eye qid; dispense 3.5 g

3. Tobramycin (0.3%) ophthalmic solution or ointment (Tobrex) [B] Solution: apply 1-2 drops to affected eye q 2-4 h; dispense 5 mL Ointment: apply to lid of affected eye q4h; dispense 3.5 g

For Pseudomonas coverage (see Note3, below)

1. Ciprofloxacin (0.3%) ophthalmic solution (Cipro): 2 drops to affected eye q2h while awake for 2 days, then q4h for 5 days [C]

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