What is the first-line treatment for bacterial conjunctivitis?

The first-line treatment for bacterial conjunctivitis typically includes the use of topical antibiotics to effectively eradicate the infection. Azithromycin and erythromycin ointments are commonly used because they target a broad spectrum of bacteria commonly responsible for conjunctivitis, such as Staphylococcus and Streptococcus species.

Azithromycin is favored for its convenience of dosing and broad activity against various pathogens, while erythromycin is also effective and has the added benefit of being gentler on the eyes, making it a good choice for sensitive populations, such as those who may have difficulty using drops. This combination of efficacy and patient tolerance makes azithromycin or erythromycin ointment the preferred choice in most clinical guidelines for the initial management of bacterial conjunctivitis.

In contrast, other options like gentamicin, tobramycin, and ofloxacin drops, while effective, are not typically the first-line treatments in many cases. Gentamicin and tobramycin can be reserved for more resistant infections or specific bacterial types, and ofloxacin, though effective, is often not prioritized as the first choice due to the availability of other, more straightforward options. Therefore, azithromycin or erythromycin ointment is often the best initial treatment for bacterial conjunctivitis.