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?”

  • tosha

    My 3yo son was diagnosed with pink eye (eyelid drooping, green discharge, eye is pink, pain when I touch his eye to clean it). The doctor prescribed Polymyxin, 1 drop, 3 times a day. After a day of treatment there’s still discharge but around his eye has become very swollen. Before he looked like a boxer a day or 2 after a fight & now he looks like the fight just ended! Could this be an allergic reaction?

    When my oldest had it 4 years ago the drops cleared it up in less than 24hrs but I can’t find out what he was given. I don’t think this was it.

  • ari

    if you had no symptoms in another house, thats solid evidence its environmental. try to track down whats causing it.

  • Andrea

    Thanks, doc. Chlamydia not likely. Happily married 6 years, been together 17. Not every realtionship is perfect but I have to say ours is pretty darn close. Best friends for 17 years is saying something! Recently had a full physical and nothing is wrong. Antibiotics might work, I suppose. I did take a Z pack ipback in April but sometimes those don’t work as well as other antibiotics. Funny thing is, I slept over someone else’s house last night, and woke up with no red eye even though I didn’t have my Vigamox with me and couldn’t take it all day. Starting to think it may be environmental.

  • Dr. Ari Weitzner

    sometimes viral conj can persist for weeks or months, but its certainly uncommon. i would rule out chlymadia and treat you with doxycycline for 2 weeks, as well as your sexual partner- this is a very common cause of chronic conjunctivitis in young people. i dont know your age.

  • Andrea

    I have a question. About a month or so ago, I had an acute case of conjunctivities in my left eye. I was sitting on the couch when my eye suddenly started stinging and then white stuff came out and wouldn’t stop. I went to the eye doctor who said it was most likely viral but because of the inflammation of the eyelid he prescribed a steroid antibiotic drop. A few days later my right eye became infected which confirmed, to the doctor, that it was viral. It took about two weeks to clear completely. A few weeks later, I started waking up with red eyes and ocassionally at night there was a little white discharge in the right eye. Then one morning I woke up with white stuff coming out of my eye again. The eye was red and it appeared to clear up but I went to the doctor and he said this time it was bacterial and prescribed Vigamox (3 drops a day). The following night, my left eye started to water profusely for about an hour in the middle of the night too. It seems to have cleared except I still wake up with red eyes and some crusty stuff (very little). The right eye is still a bit scratchy slightly. The doctor also said to put a warm washcloth on the eye twice a week because he saw minor lid swelling.

    Basically I seem to have some reoccurring issues here. How do I stop this! I’ve washed everything I own, cleaned the house completely including electronics and bedding. I’ve stopped touching my eyes completely, using tissues only when necessary. I’ve thrown out all makeup and am using no makeup on or around the eyes. This is very frustrating. Is this still viral after almost two months? It’s very frustrating! Thanks.

  • Dr. Ari Weitzner

    no sulfa in it. go back to ophthalmologist and have it re-examined- some contact lens related bugs are hard to kill with regular antibiotics

  • Nicole Dowd

    I started Moxeza on Sunday and finished my 5 days yesterday. My eye is still red, itchy, burning and watery. I am allergic to Sulfa, is Sulfa in Moxeza? I am a contact lense wearer but I haven’t worn them since Saturday!

  • Ingrid

    M son was prescribed Vigamox for a very mild pink eye. He is 3 1/2 and this is the first time he’s ever had this problem. On the third dose, he got a hive-like reaction all over his body about 5 minutes after I gave him the drops. Again this has never happened for him (hives and rash all over). I could not get him to the doctor’s until tomorrow. Seeing that he has almost no pink left in his eyes, do I stop the drops tonight? I am a little upset after reading your post that the doctor even started him on this when he had very little pink to begin with. I wish I had read your post earlier. Thanks for your time and input!

  • KT

    Thanks. You provide a great service to the interwebs! PS I’m already feeling better. I can see again, and my son doesn’t think I have zombie eyes anymore 🙂

  • Dr. Ari Weitzner

    vigamox is big guns, but once you start it, you should continue. antibiotic makes sense if the discharge is gooey and yellow.
    lie on your back, close your eyes and squeezethe bottle onto the corner of your eyes- when you open your eys, the medicine will fall in. ta-da! it’s wasteful, but it works

  • KT

    Dear Dr. Weitzner-

    My eyes have been a mess for a month now. Thought it was just pollen, so I’ve been waiting for all the crust and blurred vision to go away when spring passed. In the meantime, I developed what looks like a small stye as well. Over the past few days, the discharge has increased to a thick day-glo yellow/green — let’s call it chartreuse. Sometimes my vision gets very blurred from all the goo — I would probably fail a driving vision test today. Quit wearing eye makeup and started natural drops a couple days ago, but broke down this morning and went to the doc box. She prescribed Vigamox, which is what led me here. I have an autoimmune condition, and take Plaquenil, which may have a mild affect on the immune system. Nobody in my house has pink eye, and I’m otherwise free from viral symptoms. Guess I’m just looking for someone to back up the decision to use an antibiotic, and the the top gun RX at that. It’s really hard to get it in my eye, too, because the skin around my eyes is tight from my autoimmune condition, and I can’t pull it away much to make a pouch like the instructions suggest. My first attempt rolled right down my cheek, and the second drop moistened my eye just a bit. Any suggestions on that? THANK YOU!!!

  • Dr. Ari Weitzner

    sounds viral, and i would leave it alone as long as it’s slowly improving.

  • JeffO

    My 4 yo daughter had a viral infection (moderate cold) that led to pink eye. It was immediately treated with Vigamox and within 24 hours had a severe allergic reaction causing swelling in both eyes, hypersensitivity to light and extreme restlessness. Although slowly improving after 24 hours without vigamox…Should we treat the reaction? Or just give it time? Thanks.

  • ari

    sounds like viral conjunctivitis, like ekc. there’s nothing to do except wait for it to clear. consider a mild topical steroid drop.

  • Hi Dr, dt : 21-04-2012

    Kaushal (India -Gujarat-Anand)

    My daughter had red eye on 2 nd march & 3 rd march both eye was red ( age – 5 months) , eye specialist first give us ( Gatilox – eye drop) its give us good result but after 4 to 5 days , 1 eye had swelling and so much red then eye specialist give us Nebracin Eye Ointment but after 2 to 3 days 1 eye was so much red then Eye specialist give us Vigamox , on 16th March she was good but , my wife , my father ,my Mother & self have red eye , and so much swelling and from 15 th we have lots of trouble, we were 3 times went to eye specialist thy give us” Gatifloxacin plus ketorolac ophthalmic solutation ” and “carboxymethylcellulose sodium lubricant eye drops” but on morning we all have so much swelling and eyes are so much red, tell me sir ,which disease we all have ? We have Epidemic Keratoconjunctivitis (EKC) ?

    Please give us your comment or Advise good medicine.


    Kaushal Saraiya

  • Dr. Ari Weitzner

    to maureen:
    a stye that does not resolve may be a chalazion, which requires hot compresses and antibiotic/steroid ointment. i advise going to the ophthalmologist. allergy to vigamox is pretty rare.

  • ari

    to shreya-
    sounds like you have a viral ilness. if you don’t wear contact lenses, and if no better in a week, see doctor

  • ari

    3 more months for 15 days? im not sure what that means.
    conjunctivitis typically should be treated no more than 7-10 days.

  • Maureen

    My 16 month old had what appeared to be a stye on his eyelid beneath the eyelash on Sunday. By Monday morning his eyelid was swollen. My husband took him to the pediatrician and was prescribed vigamox. When I got home around 2:30 the swelling seem to have decrease; however, after using the drop, the eyelid got red and swollen. Took him back to the pediatrician the next morning, as the eye was swollen shut by the time he woke up. However, upon getting to the doctor’s office, the swelling had reduced a bit. It’s 4 days later and his eye is still swollen. The medication doesn’t seem to be helping. His eyelid is red and swollen and the swelling no longer decrease once he’s awake and active. Could he be allergic to this medication? The one thing I had noticed earlier is that his eyelid seem to get red and swollen after administering the drop. Your thoughts please.


  • Vinita

    my 3 month old son has been prescribed vigamox…there was lot of sticky discharge coming out if the eye….now eye is fine bur still doc says to put the drops.for 3 more months for first 15 days…somehow i feel its a strong drug..should that be given to a four month old child?