BACTERIAL CONJUNCTIVITIS (NON-GONOCOCCAL)

Acute bacterial conjunctivitis is a common and usually self-limiting condition caused by direct eye contact with infected secretions. The most common isolates are S. pneumoniae, S.aureus, H. influenzae and Moraxella catarrhalis.

Clinical features:

Ø  The patient complains of redness, foreign body sensation, mucoid or mucopurulent

Ø  discharge.

Ø  Itching is much less prominent.

Ø  On examination, purulent discharge, conjunctival papillae and chemosis are seen.

Ø  If severe or recurrent, conjunctival swab for routine cultures and sensitivities and immediate Gram stain to evaluate for gonococcus.

Non- pharmacological treatment:

l  Patients   should   avoid   touching   their    eyes,                   shaking hands,  sharing handkerchiefs, towels, etc.

l  Restrict work and school for patients with significant exposure to others.

l  Frequent hand washing.

Pharmacological treatment:

1.       Use topical antibiotic therapy [moxifloxacin 0.5% drops QID or more frequent in severe cases] for 5 to 7 days.

2.       H. influenzae conjunctivitis should be treated with oral amoxicillin/clavulanic acid (20 to

3.       40 mg/kg/day in three divided doses) because of occasional extra ocular involvement (e.g., otitis media, pneumonia, and meningitis). Antibiotic therapy is adjusted according to culture and sensitivity results.

4.       If associated with dacryocystitis, systemic antibiotics are necessary.

Patient education:

Follow up every 2 to 3 days initially, then every 5 to 7 days until resolved. Maintain ocular hygiene.