Anti-infective ophthalmic preparations in general practice

Ocular infections may be bacterial, viral, fungal or parasitic in aetiology. Pharmacological preparations are available to treat infections that are caused by these groups of organisms. The majority of these preparations are intended for topical administration, although some systemically administered agents may be needed to treat or prevent specific ocular infections. This article discusses the different anti-infective options that are available to general practitioners to treat infections caused by each aetiological group. It also discusses the role that is played by povidone-iodine and antibiotic-steroid combinations to manage eye infections. A summary of all these drugs is provided in table form for easy reference. © Medpharm S Afr Fam Pract 2012;54(4):302-307 CPD Article: Anti-infective ophthalmic preparations in general practice 303 Vol 54 No 4 S Afr Fam Pract 2012 Ta bl e I: C la ss ifi ca tio n of a nt i-i nf ec tiv e op ht ha lm ic p re pa ra tio ns C la ss D ru g Ex am pl es R ou te U se D os ag e (c hi ld re n in b ra ck et s) A nt ib ac te ria l S ul ph ac et am id e (s ul ph on am id e) Le nn on -S ul ph ac et am id e ® o in tm en t To pi ca l C hl am yd ia c on ju nc tiv iti s (c om bi ne d w ith o ra l a ge nt ) Fu si di c ac id Fu ci th al m ic ® d ro ps o r o in tm en t To pi ca l S ta ph yl oc oc ca l b le ph ar iti s/ co nj un ct iv iti s S ilv er n itr at e 1% S ilv er n itr at e op ht ha lm ic s ol ut io n To pi ca l P ro ph yl ax is in n ew bo rn b ab ie s C hl or am ph en ic ol C hl or am ex ® o in tm en t a nd C hl or om yc et in ® To pi ca l C on ju nc tiv iti s, p ro ph yl ax is in n ew bo rn b ab ie s To br am yc in (a m in og ly co si de ) To br ex ® d ro ps o r o in tm en t To pi ca l C on ju nc tiv iti s, k er at iti s C ip ro flo xa ci n (fl uo ro qu in ol on e) C ilo xa n ® d ro ps o r o in tm en t To pi ca l C on ju nc tiv iti s, k er at iti s C ip ro ba y ® , C ip lo xx ® a nd C ilo flo c ® O ra l En do ph th al m iti s pr op hy la xi s/ tre at m en t 75 0 m g 2 x/ da y (5 -1 0 m g/ kg /d os e) O flo xa ci n (fl uo ro qu in ol on e) Ex oc in ® o r O ct in ® d ro ps To pi ca l C on ju nc tiv iti s, k er at iti s G at ifl ox ac in (fl uo ro qu in ol on e) Zy m ar ® d ro ps To pi ca l C on ju nc tiv iti s, k er at iti s (n ot fi rs t l in e) M ox ifl ox ac in (fl uo ro qu in ol on e) Vi ga m ox ® d ro ps To pi ca l C on ju nc tiv iti s, k er at iti s (n ot fi rs t l in e) D ox yc yc lin e C yc lid ox ® a nd D ox ita b ® O ra l Tr ac ho m a, c hl am yd ia l i nc lu si on c on ju nc tiv iti s, o th er 10 0 m g 2 x/ da y x 36 w ee ks A zi th ro m yc in Zi th ro m ax ® a nd A zi m ax ® O ra l C hl am yd ia c on ju nc tiv iti s 1 g st at (2 0 m g/ kg s ta t) C ef tr ia xo ne R oc ep hi n ® IM G on oc oc ca l c on ju nc tiv iti s/ ke ra tit is 1g s ta t ( 12 5 m g st at ) C oam ox ic la v A ug m en tin ® a nd A m ok si kl av ® O ra l P re se pt al c el lu lit is , a cu te d ac ry oc ys tit is 62 5 m g/ 12 5 m g 3 x/ da y (c he ck w ei gh t) Er yt hr om yc in Er ym yc in ® a nd B et am yc in ® O ra l N eo na ta l c hl am yd ia l c on ju nc tiv iti s (5 0 m g/ kg /d ay in 4 d os es x 2 -3 w ee ks ) A nt iv ira l A ci cl ov ir Zo vi ra x ® o ph th al m ic o in tm en t To pi ca l H er pe tic c or ne al u lc er 5 x/ da y Zo vi ra x ® , V yr oH ex al ® a nd L ov ire ® O ra l H er pe s zo st er o ph th al m ic us 80 0 m g 5 x/ da y x 710 d ay s