Conjunctivitis acute bacterial

Both acute and chronic bacterial conjunctivitis are self-limiting, except if caused by staphylococci. 

The vast majority of conjunctivitis cases are viral in nature. For acute bacterial conjunctivitis, the cause is primarily grampositive organisms.11 The primary pathogens in acute bacterial conjunctivitis are Streptococcus pneumoniae, Staphylococcus aureus, or Haemophilus influenzae.12... 

Staphylococcus, Moraxella, or other opportunistic bacteria typically cause chronic conjunctivitis.10 Moraxella infections may cluster in groups of women who share makeup.12 Both acute and chronic bacterial conjunctivitis are self-limiting except if caused by staphylococci.13 Because of this, the pathogens are rarely cultured unless the case is unresponsive to treatment. While infection typically begins in one eye, it will often spread to both within 48 hours.11... 

Treat acute bacterial conjunctivitis with broad-spectrum antibiotics. Although the condition is usually self-limiting, antibiotic treatment decreases the spread of disease to other people and prevents extraocular infection. Additionally, treatment may help decrease the risk of corneal ulceration or other complications that affect sight. Finally, treatment speeds recovery.14... 

The choice of an antibiotic agent for acute bacterial conjunctivitis is largely empiric. The initial treatment needs to include Staphylococcus coverage, but also may be chosen on the basis of cost and side-effect profile.13,14 In general, ointments are a good dosage form for children. Adults prefer drops because they do not interfere with vision.14... 

Many broad-spectrum topical antibiotics are approved to treat acute bacterial conjunctivitis (Table 60-2). Trimethoprim /polymyxin... 

Significant improvement of acute bacterial conjunctivitis should be seen within 1 week.11 Terminate treatment with topical antibiotics when the inflammation is resolved.12... 

The condition when redness of the eye and the presence of a foreignbody sensation are evident. There are many causes of conjunctivitis, but the great majority are the result of acute infection or allergy. Bacterial conjunctivitis is the most common ocular infection. 

Buznach N, Dagan R, Greenberg D. Clinical and bacterial characteristics of acute bacterial conjunctivitis in children in the antibiotic resistance era. Pediatr Infect Dis J 2005 24 823-828. 

Figure 25-3 Acute bacterial conjunctivitis with typical mucopurulent discharge arrow).

S. pneumoniae is a common cause of acute bacterial conjunctivitis in children (Figure 25-5). Concurrent upper respiratory tract infections and otitis media, especially in children younger than 4 years, are common. In moderate climates S. pneumoniae is often the cause of acute bacterial conjunctivitis epidemics. This condition commonly presents with diffusely scattered petechial hemorrhages, especially on the superior bulbar conjunctiva, a mucopurulent discharge in the lower fornix, and transient marginal corneal infiltrates. Pseudomembranes may form. 

Before the development of an effective vaccine, H. influenzae was another frequent cause of acute bacterial conjunctivitis in children that concurrently... 

Topical steroids are not indicated for most cases of acute bacterial conjunctivitis. The exception is acute conjunctivitis accompanied by severe inflammation or pseudomembranes or true membranes. Concurrent topical antibiotic-steroid therapy hastens resolution of inflammatory response however, caution is prudent in cases in which the infectious agent has not been definitively identified and until the infection has clearly responded to antibiotic therapy. 

Topical tetracycline may be nsed as an adjnnctive therapy for chlamydial infections but not for initial treatment of acute bacterial conjunctivitis. Numerous organisms are resistant to tetracycline. 

Polymyxin B is bactericidal fc>r most gram-negative organisms, especially Haemophilus and Pseudomonas species. Neisseria and Proteus species, however, are resistant. Combining polymyxin B with bacitracin or trimethoprim achieves broad-spectrum antibacterial activity for treating acute bacterial conjunctivitis. Because it is not absorbed through mucous membrane or skin tissue, polymyxin B is used primarily for superficial infections.Adverse reactions are rare. 

Wagner RS. Results of a survey of children with acute bacterial conjunctivitis treated with trimethoprim-polymyxin B ophthalmic solution. CfinTher 1995 17 875-881. 

In patients with acute bacterial conjunctivitis there were adverse drug reactions in 4 of 103 treated with gentamicin (12). The adverse effects included redness, itching, and burning, and none was serious. 

Papa V, Aragona P, Scuderi AC, Blanco AR, Zola P, Di BA, Santocono M, Milazzo G. Treatment of acute bacterial conjunctivitis with topical netilmicin. Cornea 2002 21(l) 43-7. 

In June 2007, chloramphenicol eye ointment was reclassified from prescription only (POM) to pharmacy sale (P) for the treatment of acute bacterial conjunctivitis. 

Moxifloxacin hydrochloride is a fluoroquinolone/anAbiotic. It interferes with microbial DNA synthesis. Moxifloxacin is indicated in the treatment of acute bacterial sinusitis, acute bacterial exacerbation of chroific bronchitis, community-acquired pneumonia, uncomplicated skin and skin structure infections, and conjunctivitis caused by susceptible organisms. 

Trimethoprim sulfate/polymyxin B sulfate is an antibiotic combination. Trimethoprim blocks production of tetrahy-drofoUc acid by inhibiting the enzyme dihydrofolate reductase. Polymyxin B interacts with phospholipid components of bacterial cell membranes, increasing cell-wall permeability. They are indicated in the treatment of surface ocular bacterial infections, including acute bacterial conjunctivitis and blepharoconjunctivitis caused by susceptible organisms. 

The client is diagnosed with acute bacterial conjunctivitis. Tbe bealtb-care provider prescribed erythromycin ophthalmic ointment. Which information should the nurse discuss with the client ... 

Conservative treatment of zoster-associated conjunctivitis, including cold compresses, lubricants, and decongestants, carries the lowest risk of treatment-related complications. Treatment of the acute conjunctivitis with topical broad-spectrum antibiotics may help to prevent secondary bacterial infection. Increased patient comfort by reduction of conjunctival inflammation may be affected by the use of topical steroids. Often, a combination antibiotic-steroid is used to accomplish both of these goals. In contrast to herpes simplex infection in which steroids are specifically contraindicated, topical steroids do not exacerbate herpes zoster infection. If steroids are used, the patient should be carefully monitored for intraocular pressure elevation. 

Block SL, Hedrick J,Tyler R, et al. Increasing bacterial resistance in pediatric acute conjunctivitis (1997-1998). Antimicrob Agents Chemother 2000 44 1650-1654. 

Acute viral diarrheal illness often occurs in day care centers and nursing homes. As person-to-person contact is the mechanism by which viral disease spreads, isolation techniques must be initiated. For bacterial, parasite, and protozoal infections, strict food handling, sanitation, water, and other environmental hygiene practices can prevent transmission. If diarrhea is secondary to another illness, controlling the primary condition is necessary. Antibiotics and bismuth subsalicylate are advocated to prevent traveler s diarrhea, in conjunction with treatment of drinking water and caution with consumption of fresh vegetables. 

Oral/IV use for treatment of infections of the respiratory tract, skin and skin structure, and STDs caused by susceptible organisms treatment of pertussis, diphtheria, erythrasima, intestinal amebiasis, conjunctivitis of the newborn, Legionnaires disease, listeriosis, nongonococcal urethritis, pneumonia of infancy, urogenital infections during pregnancy treatment of acute pelvic inflammatory disease, syphilis, uncomplicated urethral, endocervical, or rectal infections in adults prevention of attacks of rheumatic fever prevention of bacterial endocarditis. 

Ofloxacin interferes with microbial DNA synthesis. It is indicated in the treatment of acnte bacterial exacerbations of chronic bronchitis, commnnity acquired pneumonia, uncomplicated skin and skin structure infections, acute uncomplicated urethral and cervical gonorrhea, nongonococcal urethritis, cervicitis, acute pelvic inflammatory disease, uncomplicated cystitis, complicated urinary tract infections (UTI), and prostatitis cdiV eAhy Escherichia coli. Ophthalmic use for treatment of conjunctivitis and corneal ulcer infections caused by susceptible organisms otic use for treatment of otitis externa, chronic suppurative otitis media in patients with perforated tympanic membranes, and acute otitis media in pediatric patients with tympanostomy tubes. 

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