####
**II. Indications**

- Treatment of infection
- Prophylaxis in Eye Injury (avoid Aminoglycosides due to toxicity risk)
- Corneal Abrasion
- Chemical Eye Burn

####
**III. Medications: Most cost effective agents**

- First-line
- Trimethoprim-Polymyxin B (Polytrim) solution 1 drop four times daily
- Erythromycin 0.5% ointment nightly (or every 6 hours as single agent) for 7 days

- Broad-spectrum
- Gentamicin (Gentak) 0.3% ointment 0.5 inch every 6 hours for 7 days
- Gentamicin (Gentak) 0.3% solution 1 drop every 4 hours for 7 days
- Tobramycin (Tobrex) 0.3% solution (ointment is not generic and is expensive)
- Ciprofloxacin (Ciloxan) 0.3% ointment 0.5 inch every 8 hours for 2 days, then every 12 hours for 5 days
- Ciprofloxacin (Ciloxan) 0.3% solution 1 drop every 2 hours for 2 days, then every 4 hours while awake for 5 days
- Ofloxacin (Ocuflox) 0.3% solution 1 drop every 2 hours for 2 days, then every 6 hours while awake for 5 days
- Levofloxacin (Quixin) 0.5% solution 1 drop every 2 hours for 2 days, then every 4 hours while awake for 5 days
- Moxifloxacin (Vigamox) 0.5% solution 1 drop every 8 hours for 7 days

####
**IV. Medications: First-Line general purpose**

- Trimethoprim-Polymyxin B (Polytrim) solution 1 drop four times daily
- Sulfacetamide 10% (Bleph-10) ointment or Solution
- Typically avoid due to low efficacy and reaction risk

- Bacitracin ointment (used in stye)

####
**V. Medications: First-Line Macrolides (especially if Chlamydia suspected)**

- Erythromycin 0.5% ointment nightly (or every 6 hours as single agent) for 7 days
- Azithromycin 1% (Azasite) solution 1 drop every 12 hours for 2 days, then 1 drop daily for 5 days

####
**VI. Medications: Broad-Spectrum Fluoroquinolones**

- Precautions
- Reserve for severe infections to prevent resistance

- Ciprofloxacin (Ciloxan) 0.3% ointment 0.5 inch every 8 hours for 2 days, then every 12 hours for 5 days
- Ciprofloxacin (Ciloxan) 0.3% solution 1 drop every 2 hours for 2 days, then every 4 hours while awake for 5 days
- Ofloxacin (Ocuflox) 0.3% solution 1 drop every 2 hours for 2 days, then every 6 hours while awake for 5 days
- Levofloxacin (Quixin) 0.5% solution 1 drop every 2 hours for 2 days, then every 4 hours while awake for 5 days
- Moxifloxacin (Vigamox) 0.5% solution 1 drop every 8 hours for 7 days
- Besifloxacin (Besivance) 0.6% solution
- Gatifloxacin (Zymar) 0.3%

####
**VII. Medications: Broad-spectrum Aminoglycosides**

- Precautions
- Reserve for severe infections to prevent resistance
- Avoid if Corneal Injury (toxicity risk)

- Gentamicin (Gentak) 0.3% ointment 0.5 inch every 6 hours for 7 days
- Gentamicin (Gentak) 0.3% solution 1 drop every 4 hours for 7 days
- Tobramycin (Tobrex) 0.3% solution (ointment is not generic and is expensive)

####
**VIII. Medications: To Avoid**

- Neomycin (topical reactions are common)