Anti-Infective Eye Preparations

Preferred list (P)

CHLORAMPHENICOL

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

Indications:

• Bacterial conjunctivitis
• Corneal abrasion - use chloramphenicol ointment.
• Marginal keratitis - use chloramphenicol ointment. Where there is concurrent blepharitis, a lid hygiene routine using baby shampoo is advised. See Chapter 11. Eye: Blepharitis for further information. If a corticosteroid treatment is required please refer to Chapter 11. Eye: Corticosteroids and Anti-inflammatory Preparations for appropriate choices.

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:

• Bacterial conjunctivitis
• Corneal abrasion
• Marginal keratitis. Where there is concurrent blepharitis, a lid hygiene routine using baby shampoo is advised.
• See Chapter 11. Eye: Blepharitis for further information. If a corticosteroid treatment is required please refer to Chapter 11. Eye: Corticosteroids and Anti-inflammatory Preparations for appropriate choices.

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.

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.