Fluoroquinolones in conjunctivitis

Both ciprofloxacin and ofloxacin are licensed for external ocular infections. Both have broad spectrum bactericidal activity, particularly against Gram-negatives, but the former is more efficacious against Pseudomonas aeruginosa and the latter against Chlamydia trachomatis.

Randomised controlled trials have shown both drugs to be as effective clinically as traditional topical preparations such as chloramphenicol(1,2).

However, both drugs have a number of adverse effects e.g. eye irritation, and are expensive in comparison to chloramphenicol.

Their use should be reserved for superficial infections with known resistance to traditional first-line drugs and sensitivity to the fluoroquinolone.

Reference:

• (1) Bron, A.J., Leber, G., Rizk, S.N.M. et al. (1991). Ofloxacin compared with chloramphenicol in the management of external ocular infection. Br. J. Ophthalmol, 75, 675-679.
• (2) Power, W.J., Collum, L.M.T. et al. (1993). Evaluation of efficacy and safety of ciprofloxacin ophthalmic solution versus chloramphenicol. Eur. J. Ophthalmol, 3, 77-82.