Should We Prescribe Vigamox Eye Drops for Pink Eye?
May 6, 2009
I see many patients who are referred to me by pediatricians and ER docs, and it seems they all are taking some fourth generation fluoroquinolone like Vigamox eye drops for bacterial conjunctivitis (or pink eye). What’s up with that? Is it just plain laziness to prescribe the same thing over and over? Or is it the result of drug rep pressure? I reserve these superdrugs to contact lens wearers. Otherwise, my patients with conjunctivitis get sulfa or gentamicin or some other cheap, old medicine. I wish doctors would take a moment before reflexively prescribing Vigamox and other very powerful drugs for what is a benign, self-limited disease.
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156 Responses to “Should We Prescribe Vigamox Eye Drops for Pink Eye?”
A few days ago my 2yr old son woke up with a runny nose. The next day it was a runny nose and a cough. I didn’t think much of it besides a common cold because his nose wasn’t mucousy, only clear. That is, until the next morning when his eye was glued shut with crust and mucous. So, I took him to the doctor. They told me he had an conjunctivitis eye infection, and prescribed him vigamox. The first time I used it, he developed red spots and bumps all over his face like hives. The second time I used it on him, the hives spread all over his body and lasted for about three hours. I haven’t used it again today, although it’s instructed to be used 3 times a day. Now I just don’t know what to do. His eye is cleared up for the most part, but he’s still has a cough and runny nose.
Yes…I just found out the chlamydia is ruled out. The urinalysis I went in for has just come back negative. So now I’m waiting for my eye culture results. He took several (six containers) and at least one is checking for viruses. I’ve had four eye doctors look at me over the course of the illness. I’ve asked about herpes and they have all brushed it aside.
Now that I know it’s not an STD, I’m relieved but still perplexed. And yes, I have had repeated visble small scratches from playing with my cat, including one that caused a little blister that will not heal after several weeks. The Dr. prescribed a Z-Pak in case it’s Cat Scrach disease, but I’m waiting to start those meds until after I get the culture results. It looks like the Vigamox isn’t active against the Cat Scratch bacteria, as far as what I’ve read online.
The main area of irritation is indeed next to my tear duct. I will ask him more about that if the cultures don’t reveal anything. And I will post here with the outcome.
Thank you very, very much for your input.
you have ruled out chlamydia.
the swollen gland is very suspicious for cat scratch, but it’s usually a self-limited disease and should be gone after a few weeks after your last exposure- unless you keep getting scratched (even tiny ones that you can barely notice).
after weeks of treatment, i would doubt that more vigamox is going to help- this does not sound like a typical bacterial conjunctivitis. maybe it’s something in the tear duct? you may need a second opinion if this does not improve. 9i assume your cornea and anterior chamber are clear and therefore there is no suspicion of herpes)
I forgot to add: After my third full day of Vigamox 4x daily, the eye doesn’t seem to have improved too much…
Thanks for your response. The pinkeye has been pretty consistent in one eye for the last month. I am trying to figure out what could have happened. I’ve not had any sexual contact since my last (to my knowledge) monogamous relationship, and both he and I were tested (negative) for STD’s before any relations occurred (and we are both middle-aged). So if I am now positive somehow months after our breakup for chlamydia, I would of feel compelled to contact the ex-boyfriend, because it must mean he was also positive. But of course I don’t want to go through that if it’s at all possible I contracted it in some other way. I am really hoping it’s not an STD. The doctor also mentioned something about Cat Scratch disease, as I have been exposed to cat scratches from pets.
viral conj should not wax and wane. conj that lingers for months in a young, sexually active person is, in my book, chlamydia until proven otherwise. i agree with taking cultures, and you should be put on oral antibiotics like doxycycline for 2 weeks. i suppose it’s possible to catch chlamydia from non-sexual contact, but boy, that would be a rare bird. by the way, it’s not uncommon for the cultures to come back negative even though there is chlamydia there- so i like to treat with oral antibiotics anyway and if the patient is cured, i consider that a likely case- i leave it to the patient to deal with their sexual partner.
I’ve had recurring pinkeye on and off for about 2 months. It appears to be more viral than bacterial, but my doctor is doing cultures and I’m awaiting the results. He off-handedly mentioned that due to a swollen gland on the infected side, I may have chlamydia in the eye. I have been treated thus far with Tobradex and erythromyacin ointment to no avail. I’m now on Vigamox. My question is: Is there ANY way I may have caught chlamydia in the eye from another person, without sexual contact? Is it contagious for instance on surfaces, like other bugs? Also, to my knowledge I am currently STD-free although I will go in for testing just to be certain. Thank you…I am very worried as I wait for the results of the cultures.
yes-you are asking for problems if you wear contact lenses while being treated, but conjunctivitis rarely lasts more than a week or so. if you are still having issues, i urge you to get a follow up exam.
Dear Dr. Weitzner,
I read your above comments and I too have been diagnosed with pink eye. My left eye has been cloudy for almost two months and I wear contacts. I am guessing that this is why it has not cleared up on its own. I was prescribed Vigamox but told not to wear a lense in my left eye during treatment. My glasses are really out of date and I cannot stand to wear them. Am I asking for problems by continuing to wear contacts during treatment though I am using a new lense each day? Thanks so much!
pink eye is not typically painful.
you are taking quite a few drops for pinkeye! since you started them, you probably should finish. side effects are very rare.
putting drops in the eye requires no special technique. just pull your lid down and squeeze. do it any way that you like.
and im just having red eyes no green discharge in my eyes.. just watery and a little painful 🙂
hi im having a pink eye now for about a week. my doctor prescribe me a vigamox,( 1 drop every 2 hrs )pred forte ( every 2 hrs)and a proifen (every 6 hrs) and since he cant speak english fluently i didnt have the chance to ask on how to do the dropping properly.. and im afraid of the side effects. is it always painful?
exactly right! i believe that in the third world, betadine drops are used for all kinds of conjunctivitis, and it works great- both bacteria and viral, and cheap as hell- pennies per dose. if my wife allows, i will use it on my kids!
Dr. Weitzner,
I totally agree with you about the over-use of the fluoroquinolones. It’s like pounding in a small finish nail with a sledge hammer! Great when needed, but feeding the share-holders otherwise. Have you considered a 5% opthal. betadine lavage for those suffering from EKC? It is what I use to treat my own kids. Its a little irritating initially, but shortens the duration to 1-2 days instead of a week or so. Off label, but very effective. Proparacaine, Betadine lavage for 1 minute, wiping lids as well, NSAIDS for comfort and Lotemax to reduce the inflammation. Your wife will then love you even more when the kids aren’t stuck at home!
sounds like you have blepharitis, a common chronic condition of the lids. But you will have to see an ophthalmologist to get the correct diagnosis and treatment.
For about 5 months now, I’ve been having sore eye on and off. One week it would be my left eye, than a week or two later, it would be my right eye. It alternates back an forth. The symptom last from a day to a week, depending. I have not yet seen a doctor regarding this issue and just have used warm/hot tea bags and towels over my sore eye. It would start w/ either my upper or lower eye lid showing signs of pinkish than the soreness begins. Sometimes it swells a little bit and some mornings, there are the sticky stuff that makes my eye shut and can’t open. Sometimes there’s the flaky stuff on my eye and can make it hard to open as well, but just on the eye that is sore. I haven’t have any discharge, not that I can recall. But sometimes it does make a squeaking noise when I rub gently on the sore eye and then it would feel sticky. Maybe clear discharge after rubbing it. I wash my face w/ clean towels every night and sometimes wash my eyes with baby shampoo with warm water. I don’t even wear eye makeup.
I don’t know if I should go see a doctor to prescribe my any antibiotic because reading the comments above about some of the prescription, I don’t know if I should or not. Besides, I don’t have really good health coverage right now. I pay full price for doctor’s visit and any lab work done. But if I have to go see a doctor, I will.
I did have stye once last year and used the stye eye drop. It went away after a week, but a few months later, I started to develop the sore eyes. Any advice would be so helpful. Thanks.
usually pink eye is contagious for about a week.
rarely, conjunctivitis can irritate the eye for weeks or months. i dont think antibiotics are of any value at this point, but maybe steroid drops. im afraid you need to see an ophthalmologist at this point.
And now, I don’t know if this matters but my eyes are itchy were as for the last week they weren’t. Could I have something else going on other than pink eye? Should I continue the gent drops? And is it possible I’m still contagious after all this time? No real eye drainage in a week, more like “sleepy” in my eyes if anything. Sorry this has been going on in our house for over a month now and ready to turn the page on it. Thanks again.
Thank you ahead of time for your time. My 10 month old had pink eye, then my 4 year old, then back to my 10 month old and then my husband. My children took the vigamox (my husband the sulfa drops) and were all much improved within days and healed by a week. I got something after they were all better. It started with waking up with one eye pink, swollen, and crusted shut. I started the sulfa drops and the next day woke up with both eyes that way. The sulfa drops burned terribly every time I put them in. My eyes were more red after every application so after 36 hours I started using gent drops. My eyes are much better but I have been on the gent drops for a week now and when I wake up my eyes are STILL pink and my vision is hazy-like. The pink and haziness clear up after drops and being awake for a while. I was only supposed to use the drops for 7 days but I’m almost afraid to stop using them. (BTW I’ve also been using Naphcon-A allergy drops to help with the redness.)
Thank you so much for your advice!
