Bacterial - Acute

- Usually begins unilaterally with involvement of the second eye within 24 to 48 hours.

- Moderate purulent discharge, conjunctival hyperemia, and eyelid swelling/redness. Preauricular lymphadenopathy usually absent.

- Cultures are not recommended unless infection is not resolving with standard therapy.

- Often self-limiting.

- Oral antibiotics not indicated.

- Topical corticosteroids not recommended.

- Avoid eye patching.

Usual Pathogens

S. pneumoniae
H. influenzae
S. aureus
Group A Streptococci
Moraxella spp
Proteus spp


Empiric Therapy Dose Duration
Warm compresses


Ophthalmic Solution (adults)

Empiric Therapy Dose Duration
Gramicidin-Polymyxin B qid 7-10 days
Tobramycin 0.3% qid 7-10 days

Ophthalmic Ointment (infants/children)

Empiric Therapy Dose Duration
Bacitricin-Polymyxin B qid 7-10 days
Erythromycin 0.5% qid 7-10 days