Topical antibiotics for the eye
- Drugs and toxicity
Antibiotic drops shorten bacterial conjunctivitis and protect abrasions; keratitis needs cultures and intensive drops from ophthalmology.
See it in 3D: Cornea
What it is
Topical antibiotics are used for bacterial conjunctivitis, to prevent infection of corneal abrasions and after eye surgery, and intensively for bacterial keratitis. Bacterial conjunctivitis is often self-limiting; antibiotics shorten it and allow earlier return to school or work. Keratitis is a different problem: it needs a culture and frequent, often fortified, drops under ophthalmology.
What to know
- Common classes: chloramphenicol, aminoglycosides (tobramycin, gentamicin), fluoroquinolones (moxifloxacin, ciprofloxacin, ofloxacin), macrolides (azithromycin, erythromycin ointment).
- Fluoroquinolones are preferred for contact lens wearers because they cover Pseudomonas.
- Ointments last longer and suit children and night use; drops are better during the day.
- Aminoglycosides can be toxic to the corneal epithelium with long use.
Toxicity and risks
- Viral conjunctivitis, the most common type, does not respond to antibiotics.
- Neonatal, gonococcal and chlamydial conjunctivitis need systemic treatment.
- Antibiotic-steroid combinations should be left to ophthalmology.
Next step / Initial management
- Uncomplicated bacterial conjunctivitis: hygiene and a short course of a broad-spectrum topical antibiotic; review if not better in a few days.
- Corneal abrasion: prophylactic topical antibiotic until healed; a fluoroquinolone if the patient wears contact lenses.
- Corneal infiltrate or ulcer: same-day ophthalmology for culture and intensive treatment.
- Avoid prolonged or repeated courses without a diagnosis.
Test yourself
Think of the answer, then tap the question to see it.
Which topical antibiotic class is preferred in a contact lens wearer with an abrasion?
A fluoroquinolone, because it covers Pseudomonas.
Does viral conjunctivitis respond to antibiotics?
No; it is managed with hygiene and comfort measures.
How is bacterial keratitis managed differently from conjunctivitis?
With same-day ophthalmology, corneal culture and intensive, often fortified, antibiotic drops.
Connections
See it in 3D1
The structures of Durgical's 3D anatomy where it is found.
Educational content; not a clinical guideline and no substitute for assessment by a health professional. For sudden visual loss, severe eye pain, a chemical burn or an eye injury, go to an emergency department at once.
Sources: Bacterial Conjunctivitis (StatPearls Publishing (NCBI Bookshelf), 2026); Bacterial Keratitis (StatPearls Publishing (NCBI Bookshelf), 2023).
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Representative model, for educational purposes only.