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?”
Forgot to mention, claritin that i started taking from first day and i suspect pollen allergy but previously i got watery eyes but never conjunctivitis due to pollen.
Hi this is very informative. I have gotten pink eye since two days. First day it was red and with lot of yellow-green discharge and i used naphazoline drops to get rid of redness. I dint have runny nose or sore throat. Second day i felt some throat irritation with less discharge and very less redness. I used zaditor from second day. On third day, sore throat cleared up, no discharge, very less redness but my pain on eyelids started. I do not want the extreme treatments and this is why i am asking you here. Should i see dr?
expired medicines are not unsafe- just slightly less effective.
Is it really unsafe to use Vigamox after the 28 day expiration?
since you started the vigamox, continue 4 times a day. if not a lot better by tomorrow, go to ophthalmologist.
Very thankful to be able to ask this question. My 9 year old son woke up with crusty, very red eyes. It was Saturday (pedi closed) so I started vigamox I had on-hand (new bottle). Twenty four hours later his eyes are still exceptionally red and crusty again when he woke up. They look even worse.
I have 3 boys and we’ve had pink eye over the years, and this looked the same initially. But today his eyes are even redder and angrier-looking, than I’ve ever seen in my kids. I cleaned the crustiness off his eyes with warm water/cloth, and did more drops.
Does this sound viral? In the past, vigamox always cleared up the infection in a day or so. It’s scary to see his eyes so red. I’m thinking I will take him to the urgent pedi care today when they open.
It’s freaking me out a bit if there’s nothing that can be done. I’m washing/cleaning like crazy- is it possible that my other kids won’t get it? I keep reading how contagious it is. Eek! Thank you for your insight.
likely a reaction to new solution- go back to your old brand.
a red eye in a contact lens wearer can be serious- use vigamox every 15 min for 6 hours, the every hour, and see an ophthalmologist very soon, like today or tomorrow.
Put in new contacts with new solution @ 630 am. By 10 am right eye red. Took contacts out. By 4 pm had yellow discharge from left eye. I keep seeing references to contact lens wearers with all bets off? I just started Vigamox but am wondering if as a contact lens wearer I should do more? Also could the lens or solution been contaminated? Just opened but the infection was so rapid!
Thanks for your response.
for viral conjunctivitis, we typically keep kids out of school for a week. for bacterial, i usually allow them to return when the discharge stops. i am not familiar with any research on this.
How soon can a child return to school after starting Moxeza? I had a healthcare provider state that after one dose the child can return to school–and said there is research to support this. Any thoughts?
you should not have stopped treatment after 2 days for a presumed bacterial infection. otherwise, you just kill off the weaker, susceptible bacteria, while the stronger ones thrive and are harder to kill. as a general rule in medicine, one needs to treat an infection for at least 7 days, even if it looks all better.
sounds like your child simply had a recurrence after inadequate treatment. why 1 eye takes a day longer than other- no good reason. re-start the drops and take for a full week and go back to ophthalmologist if not getting better.
Hi,
My son developed a low grade case of pink eye, both eyes were pink and had crust in the corners, and slimy crust on his eyes, i called the Pediatriacian the day i saw it come on. he gave him 1 Rx: Polymyxin B Sulfate and Trimethoprim Ophthalmic solution. his eyes seemed to clear up in the next 2 days!all gone!! My pedi said it should be all clear in 2 days wich it was… But 5 days later one of his upper eye lids swelled up and puffiness around the bottom, and i started given him the drops again bc i thought maybe its was somthing with the pink eye again and now the next day his other eye is swollen, so now both eyes are swollen. Do u you know whats going on? do u know why 1 eye reacted a day after the other?
oral antibiotics a good idea in a 20 month old if the conjunctivitis looks bad and may be spreading to the lids. it also sounds like baby has ear infection- for that, antibiotics typically have little efficacy according to an important article that came out a couple of years ago,..
I’ve read through the comments and appreciate all the info, but I was wondering if oral antibiotics are also neccesary for a 20 month-old if the pink eye (began 5 days ago and consists of redness and swelling around the eye and moderate yellow thick drainage) seems to be associated with occasional fever, sore throat, nasal drainage, and pulling at the right ear. She had a cold with nasal symptoms and fussiness prior to the pink eye developing. The fever was first noted 1 day after the red pussy eyes and she began pulling at her right ear and speaking with a hoarse voice 3 days later. She seems to get 4-5 colds each winter (this is her 2nd so far this winter) and they often include pulling at ears, but never much of a fever. She has never been on any medications, and I’d rather not have her take oral antibiotics if they are not needed. We are keeping her eyes clean with warm washcloths an needed (approx 6 times per day) but her eyes are worse everyday. I am also debating whether to take her to the eye doctor or to the NP who has done her well child exams.
About a month, or so, ago, I came down with conjuntivitis, and was prescribed a course of polymyxin-b/trimethoprimopth solution. 1-2 drops every 4-6 hours for five days. By day 4, it burned like acid to put it in my eye. On day 5, there was no improvement. I self administered for another two days, just in case. No improvement.
Returned to clinic, was reassessed, and given ofloxacin. Instill two drops four times daily, for five days. Within 24 hours, there was a 85% improvement, significant reduction in redness, no itching, and no discharge to speak of. By day five, improvement had reached about 95%. Remained on treatment another two days, but the symptoms have gotten worse. Itchy, light swelling, redness, a whitish, stringy, sticky discharge. No ear issues, no throat issues.
Any thoughts on what the next treatment might be?
if it looks like pus, it is likely bacterial and should be treated with antibiotic drops. i would keep her away from daycare for about a week. hand-washing is best way to control spread.
My 6 year old has pinkeye and was prescribed sulfacetmide na 10% and has been taking for 3 days her eyes are less red and still a bit crusty when can she return to school ?
My 5 year old is c/o that her eyes are itchy and they burn. I have noticed her eyes are red with a thick yellow drainage that looks like pus. Her eyes also stick together. She doesn’t c/o of any blurred vision or vision changes except when she looks at bright lights. The pain is not too bad. She has no other complaints but does go to day care a few days a week where there are other kids who have had similar symptoms. Is this bacterial conjunctivitis (pink eye)? What would you prescribe and how long should I keep her out of daycare? What are some other alternative medications? How can I comfort her and provide infection control besides handwashing? Thank you.
You can’t possibly mean blisters on retina. Maybe you meant on conjunctiva or cornea? Strep invading retina would mean your child was admitted to the ICU. Cerainly would not treat strep invasion of retina with vigamox drops- it would absolutely mean IV antibiotics, again probably in the ICU, and it most certainly would not resolve in a couple of days.
I also treat conjunctivitis when I suspect its bacterial. We all do. The issue here is treating what looks and smells like viral conjunctivitis, which good doctors know is a bad idea and only increases odds of more resistant oranisms we CAN’T treat.
I would disagree about waiting two weeks. I waited a week for my son, and he almost wound up with permanent vision loss. He ended up with the strep causing bacteria in his eye. He had blisters on his retina when I finally took him to the eye doctor. Two days of Vigamox and he looked 100% better. I’m so happy my optometrist treated his symptoms aggressively. She’s the best!
