Warning
For further information and advice regarding penicillin allergy, dosing, important interactions/adverse effects/safety considerations and antimicrobial stewardship please refer to the USER GUIDE.

Conjunctivitis

Most cases of acute bacterial conjunctivitis are self-limiting and resolve without antibiotic treatment

 

Cases where antibiotics are required (e.g. severe, not resolved spontaneously after 5 days)

Chloramphenicol 0.5% eye dropsdose or 1% ointmentdose (available via pharmacy first)

Duration: Continue use until 48 hours after infection has cleared. 

 

Orbital / peri-orbital cellulitis

Orbital cellulitis & peri-orbital cellulitis (moderate/severe)

This is a medical emergency requiring urgent hospital admission and advice from ophthalmology

 

Peri-orbital cellulitis (Mild / Uncomplicated)

Children:

Refer to: Hospital: Paediatrics (Skin and Soft tissue, Peri-orbital cellulitis / Orbital cellulitis)

 

Adults:

Co-amoxiclav dose

Penicillin Allergy or Known MRSA: Doxycycline dose + metronidazole dose (Pregnant: Clarithromycin *,dose + metronidazole dose)

* Review previous microbiology results. If colonised with clarithromycin-resistant MRSA, seek advice from Consultant Microbiologist for alternative agent.

Duration: 5 - 7 days

 

Ophthalmic shingles

Signs OR symptoms of eye involvement: refer to ophthalmology and/or admit to hospital

Start treatment up to 7 days after onset of rash.

 

Aciclovir dose

Add lubricating eye drops if lesions near eyelid
Duration: 7 days

 

Editorial Information

Last reviewed: 31/07/2024

Next review date: 31/07/2027

Version: V1.0

Approved By: AMT (23.07.24) and ADTC (31.07.24)

Reviewer name(s): Jon van Aartsen (consultant microbiologist), Claire Mitchell (pharmacist).