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?”

  • ari

    looks like you have typical viral conjunctivitis- the sore throat certainly suggests it. i would leave it alone. you are contagious for about a week. i dont know how long the virus can survive on surfaces- but typically, it is spread via hand to mouth, and we advise not to share towels or pillowcases. we dont catch disease by by sweat or heat or cold. its the virus.

  • Mary

    I forgot to mentioned I also have Tobradex ointment. I researched online and I believe is used for pink eye. I do not how often I should apply it or if I should use something else.

    Mary

  • Mary

    Dr. Weitzner,

    I’m a 39 year old female. I was exposed to someone who had pink eye December 25th. He was prescribed Gentamicin Sulfate and I never saw him again until January 1st his eye looked normal and this is why he was able to get together with his friends for new year’s day. Before I even saw my friend I had develop a sore throat at the time I thought it was just a cold coming but it never changed. Yesterday although I was still having lots of pain I went snowboarding. I was sweating very much and the temperature was very low. Once I got home I took a hot shower and realized my right eye was a bit pink. I thought it was maybe just the shampoo or the steam for the shower and I didn’t think much about it. This morning I woke up with my eye shut close and a clear discharge all over it. I was afraid I might have hit my eye somehow snowboarding. I was not wearing eye protection and thought maybe the snow blowing straight to my face hit my eye causing the redness. My left eye by now also has clear discharge. I do not have any itching or pain. My eyes are not swollen but they are irritated from me cleaning them over and over. I currently do not have insurance but I do have recent medicine prescribed to me from when I had Lasik surgery about six months ago. I checked the date on the drops and they are still good. I have Vigamox .05 and Omnipred eyes. I know you would not normally prescribed Vigamox but it’s all I have now. My questions are the following, do you think I could use both drops? and how often? Is there anything over the counter I can buy to help me. I’m also afraid of getting better and getting contiguous again from touching something around the house I have touch and its infected. How long can the virus or bacteria live on things? Someone had also mentioned that maybe what I have it related to my sore throat. Can this be possible? It’s my first time I have ever had what I think is “pink eye”. Thank you for any insight you can provide me with.

    Regards,

    Mary

  • Dr. Ari Weitzner

    i respectfully, and in strong terms, disagree. a doctor who answers like this on his boards would fail immediately. no infectious disease doctor thinks like this, and all they do all day is teach doctors just the opposite. in fact, it is precisely this kind of thinking which leads to resistance among “superdrugs” and created the disaster of mrsa and other bugs that we just cant kill, and so people die. especially in conjunctivitis, which goes away whether you treat it or not (i dont even treat my own children), it is plain silly and wasteful to use a superdrug. it would no different that using a superdrug after you pop a zit- thats how silly it is. of course, in serious infections, the infectious disease doctors will urge superdrugs. but in order for superdrugs to remain “super”, your thinking must be rejected. its not just cost (and cost is important, for there are only “x” dollars, and if you waste it on superdrugs, there wont be enough money for other important things). using superdrugs when not truly necessary is just plain bad medicine and increases the odds of resistance.

  • Saph

    Sorry but I disagree, there are few body parts I don’t like to gamble with, one of them being the eye. I’d rather have a “superdrug” over an “oldie but goodie” for almost anything anyway. The concept of saving 60-70 dollars on something as important as your health, specially your eyes, is somewhat backwards to me. Forgo the extra clothes, going out, or anything else and get the medicine please. Yeah we’re on a recession but 90 bux is what we spend at the movies or any restaurant these days, it’s not world shattering money.

    Just the opposite, if I go to the doctor and he prescribes me something and later I find out there was a more expensive and better option an he didn’t even give me the choice I would be downrating him on md reviews and really angry and have had a doctors office refund me exam and med. A doctor prescribed me sulfa once, I asked for something else…

  • ari

    i am not familiar with moxeza. if the eye is so swollen shut, i would see an ophthalmologist

  • Lauren R.

    Pink Eye has been going through my childrens school for the past 2 months – My first 2 children had it last month and it cleared up within 24 hours on AK-TOB drops. (I continued the drops 3x a day for 5 days as prescribed). My third child has it now and it is so much worse – eye swollen shut! I started her on the refill of AK-TOB yesterday that I had filled and called my doctor thinking that the bacteria is simply getting resistant to the drops since it has been passed to over 100 children in the school. He prescribed Moxeza. She has now had 1 dose of AK-TOB and 2 doses of Moxeza – which one is better and which should I continue using?

  • ari

    off the record i would say its probably not necessary to wake him up, as there is no good evidence that antibiotic drops really can prevent infection inside the eyeball from a foreign body. why not just put a few drops on the inner corner of his eye as he lays flat, then gently lift his eyelid just slightly- the medicine will fall right into his eye. i advise this to all my patients, young or old, who have trouble taking drops. it’s wasteful, but it works.

  • carol

    My Grandson stuck a stick in his eye and and is going to have to have cataract surgery.The emergency doctors glued the cut on his eye and prescribed vigamox every two hours around the clock. He is five years old and it is becoming difficult to wake him in the middle of the night to administer the drops. Do you think using the drops every two hours until he falls asleep is okay. Or should we continue to wake him during the night?

  • ari

    dont be sad. im sure you will be fine!

  • Mohd

    i was diagnosed with viral pink eye, and the doctor gave me vigamox to use it every 2 hours for ten day, and a cream to put at night.. i didnt use it every 2 hours, i use it 4 times aday and For the first 5 days it got worse, i stoppped the cream and after two days it became better…then i went to the doctor again and he told me that im 70% ok but i should use the med 1 more week, so i put the cream again in the same night, and i woke up with pain and all redness and swollen came back again.. …
    By searching the net i found that there is no cure for and it should run it corse… So i will stop the all the med…..its day 10 now.. im so sadddd… Sorry about my english

  • Dr. Ari Weitzner

    hard to say. best advice at this point is to continue the keflex and vigamox for the full course.

  • Ivan

    Ok. So I went to my doctor Monday morning and told him the same story about the e.r as I told u on Saturday. Was prescribed keflex bactrim and vigamox. According to the e.r doctor he didn’t like the fact that I had a fever of 101 and that my face looked a little swollen on my cheek area so he said that his evaluation was facial cellulitis w eye conjectuvitis. He didn’t do a culture test and I don’t know why but I did get that muscle injection antibiotic. Now on Monday morning I went to my regular doc and she told me he though I “may” have been coming down w cellulitis and he didn’t like the fact that I was starting a fever so she said he took an aggresive move to give me those medications. Although she also didn’t like the fact that I’m taking two oral antibiotics. She told me to discontinue the bactrim after day 5 and just continue the vigamox and keflex as noted. My eyes aren’t sore anymore and no itch and no gluey residue. I am also not affected to the light and they’re not pink more like a light pink and white. I feel I’m getting better and today the doctor said it was more than likely bacterial since the meds kicked in 4 days til major improvement. Do u agree w what she says? Also should I stop using the bactrim twice a day on day 5 like she says?

  • ari

    what do you mean by “so many symptoms”? all you state is “flare ups”.
    arithromycin is great for blepharitis, which typically waxes and wanes throughout life, and therefore needs life-long treatment. herpes keratitis is a very different disease- sometimes hard to diagnose after the acute event. perhaps you should see a cornea specialist for 1 more opinion.

  • Bob

    Thank you doctor for all the information. I have recurring flare ups of red eye in my left eye. One ophthalmologist diagnosed herpes keratitis based on ulceration while at another time another doc diagnosed blepharitis. This current outbreak my GP has me on Vigamox and arithromycin based on swelling around the eye! Can one condition cause so many symptoms?

  • Dr. Ari Weitzner

    Without hearing more, I would say nothing to worry about, but as always in such situations, please consult your doctor.

  • Mohamed Dukuly

    I accidentally used vigamox for nearly a month without realizing that only 7 days were described by my doctor. What will be my side effect if any ?. Please give me your professional advice as I am really concerned.

  • Dr. Ari Weitzner

    intramuscular antibx? very strange- not sure what to make of it. also, dont know why you are taking bactrim and keflex for mere conjunctivitis. i am not getting enough info here- doesnt make sense. something else is going on- maybe they suspect cellulitis?

  • Ivan

    Hello, I’m the type of person that rarely goes to the dr unless necessary. My daughter had pink eye for a week and she cleared up. Soon after I started w the symptoms 5 days ago and I bought similisan drops and didn’t help. Since my eye was red and area was mildly swollen I decided to visit the E.R on day 4, which was last night Aug 12 (the same day as day 4 my other eye began getting red but no swelling). Now I may also note that I had been working 12 hours all those days w roughly 5 hrs of sleep. I wear contacts but I immediately removed them when redness began. Now this is my question they injected me w a muscualr antibiotic and prescribed vigamox, keflex, and bactrim ds. I’m in bed resting it all off and have taken the meds and they feel good but is it safe to take that many antibiotics? Also how long after taking them can I expect to feel redness gone? Thanks ahead of time

  • ari

    a body rash would be pretty rare from a drop, so ordinarily i think you should call your doctor and get another drop. since he’s getting better, and it sounds like he had a cold in the eye (viral conjunctivitis), i doubt he needs anything anyway.