Drug Therapy for Conjunctivitis

Drug Therapy for Conjunctivitis

Conjunctivitis, commonly known as pink eye, can be caused by bacteria, viruses, allergens, or irritants. Treatment depends on the underlying cause:

Bacterial Conjunctivitis

• Topical Antibiotics:
  • Erythromycin Ophthalmic Ointment: Applied 2-4 times a day.
  • Trimethoprim-Polymyxin B Drops: 1-2 drops 4 times a day.
  • Fluoroquinolones (e.g., Ciprofloxacin, Ofloxacin): Used in severe cases or contact lens wearers, 1-2 drops every 2 hours while awake.

Viral Conjunctivitis

• Supportive Care:
  • Artificial Tears: Provide symptomatic relief.
  • Antihistamine/Decongestant Drops: For comfort (e.g., Naphazoline/Pheniramine).
• Antiviral Medication:
  • Generally not required, but in cases of herpes simplex virus, Topical Ganciclovir or Oral Acyclovir may be prescribed.

Allergic Conjunctivitis

• Antihistamine/Mast Cell Stabilizer Drops:
  • Olopatadine: 1-2 times daily.
  • Ketotifen: Twice daily.
• Decongestant Drops:
  • Naphazoline: For short-term use to reduce redness and swelling.
• Corticosteroid Drops:
  • Loteprednol: For severe cases under medical supervision.

Irritant Conjunctivitis

• Removal of the Irritant:
  • Flush eyes with saline solution.
• Supportive Care:
  • Artificial tears for symptomatic relief.

Drug Therapy for Otitis Media

Otitis media, an infection or inflammation of the middle ear, is common in children but can also occur in adults. Treatment varies depending on whether the condition is acute (AOM) or chronic (COM).

Acute Otitis Media (AOM)

• First-Line Antibiotic:
  • Amoxicillin: 80-90 mg/kg/day in divided doses every 12 hours.
• Amoxicillin-Clavulanate: Used if amoxicillin treatment fails or if the child has taken antibiotics recently, 90 mg/kg/day of amoxicillin component in divided doses every 12 hours.
• Alternative Antibiotics:
  • Cefdinir, Cefuroxime, Cefpodoxime: For penicillin-allergic patients without an immediate-type hypersensitivity reaction.
  • Azithromycin or Clarithromycin: For those with penicillin allergy.

Recurrent Otitis Media

• Antibiotic Prophylaxis:
  • May be considered in recurrent cases but is generally avoided due to antibiotic resistance concerns.
• Tympanostomy Tubes:
  • Surgically placed tubes to ventilate the middle ear and prevent fluid accumulation.

Chronic Otitis Media (COM)

• Topical Antibiotics:
  • Ciprofloxacin Drops: Often used for chronic suppurative otitis media with perforation.
• Oral Antibiotics:
  • Not typically recommended unless there is an acute exacerbation.

Pain Management for Both AOM and COM

• Analgesics:
  • Acetaminophen or Ibuprofen: For pain and fever control.

Adjunctive Therapy

• Decongestants and Antihistamines:
  • Generally not recommended for AOM but may be used in specific cases under medical guidance.

Conclusion

The drug therapy for conjunctivitis and otitis media requires an accurate diagnosis to determine the cause and appropriate treatment. Bacterial infections often require antibiotics, whereas viral and allergic cases rely on supportive care and symptom management. Proper diagnosis and treatment adherence are crucial for effective management and recovery.