Anti-Infective Eye Preparations

Warning

General Notes

For viral conjunctivitis antibacterial preparations are ineffective.

Antibacterials

Preferred list (P)

CHLORAMPHENICOL

  • Chloramphenicol is a potent broad spectrum antibiotic.
  • Available as 0.5% eye drops and 1% ointment.

Indications:

 

Total list (T)

GENTAMICIN 0.3% eye/ear drops

OFLOXACIN 0.3% eye drops

  • Restriction: Do not use as a first line antibiotic, reserve for resistant cases and more serious keratitis. 

  • Corneal ulcers: For this indication, the formulary category is S1.

CIPROFLOXACIN 0.3% eye drops

 

Specialist initiation (S1)

FUSIDIC ACID 1% eye drops

Indications:

Restrictions:

  • For patients with known allergy to chloramphenicol or in pregnancy.
  • Fusidic acid and its salts are narrow spectrum antibiotics reserved for staphylococcal infections.

 

Specialist use only (S2)

GENTAMICIN 1.5% eye drops

  • Indication: corneal ulcer
  • Unlicensed preparation.

CEFUROXIME 5% eye drops

  • Indication: corneal ulcer
  • Unlicensed preparation.
  • Approximately 10% of patients with hypersensitivity to penicillins will also be allergic to cephalosporins.

Antivirals

Preferred list (P)

GANCICLOVIR 0.15% eye gel

Specialist initiation (S1)

ACICLOVIR tablets

  • In recurrent herpes simplex keratitis a Consultant Ophthalmologist may advise a longer treatment length.
  • Therapy should be interrupted every six to twelve months for reassessment of the condition.

NHSL Joint Adult Formulary Key

To indicate the category of a formulary medicine, updated sections adopt the following key:

Preferred list (P): First-line formulary choices.

Total list (T): Alternative choices when preferred list options not effective/not tolerated, or not indicated.

Specialist initiation (S1): Specialist initiation, or on the advice of a Consultant or Specialist Practitioner in this therapeutic area. Continuation in primary care is acceptable.

Specialist use only (S2): Supply via hospital, Homecare Service or a hospital based prescription (HBP) for dispensing by community pharmacy. Not prescribed in primary care setting.

Editorial Information

Last reviewed: 31/01/2022

Next review date: 31/01/2025

Author(s): NHSL.

Version: Please refer to the introduction section for an explanation of the review dates above.

Approved By: ADTC

Reviewer name(s): ADTC.