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Ciprofloxacin ophthalmic drops for pink eye

Moxifloxacin belongs to a group of broad spectrum antibiotics called fluoroquinolones.  Moxifloxacin is available as an oral tablet (Avelox) and an eye drop (Vigamox).  Many parents may recognize the name Vigamox because it has become many pediatricians’ drug of choice for the treatment of bacterial conjunctivitis also know as pink ciprofloxacin ophthalmic drops for pink eye eye. This new found popularity is unfortunate because it is complete overkill for use in treating pink eye.

Conjunctivitis can be caused by a virus, bacteria, allergen or irritant in the eye.  Bacterial conjunctivitis is the typical, highly contagious pink eye with crusty, thick discharge that loves to infect our little ones. This is also the conjunctivitis that is relatively easy to treat with antibiotic eye drops.

Moxifloxacin eye drops work by inhibiting essential bacterial enzymes that leads to the destruction of the bacteria.  Moxifloxacin eye drops (Vigamox) have been approved for the treatment of bacterial conjunctivitis in children older than 1 year.  The typical dosing is one drop into each eye three times daily for seven days.

Common side effects of moxifloxacin ophthalmic drops (Vigamox) include dry and itchy eyes, blurry vision, broken blood vessels and a dull, burning pain in the eye.  Kids can also experience a weird taste, headache, rhinitis and throat irritation.

When giving the eye drops to a child, it is best to follow common precautions such as washing hands and not touching the container tip to the eye, lid, skin or other surface.  For best results, after putting drops in, have the child keep her eyes closed and apply slight pressure to the inside corner of the eye for 3 to 5 minutes.  This helps the medicine to be absorbed.  However, quite often the reality is getting a child to sit long enough to get the eye drop in can be difficult enough! It is important to note that the eye drop expires 28 days after opening.

Other eye drops in the same class include: ciprofloxacin (Ciloxan), ofloxacin (Ocuflox), levofloxacin (Quixin), besifloxacin (Besivance) and gatifloxacin (Zymar).  Within this class, gatifloxacin (Zymar), moxifloxacin (Vigamox) and besifloxacin (Besivance) are the strongest antibacterial eye drops.

Will moxifloxacin (Vigamox) treat my child’s pink eye? Not only will Moxifloxacin (Vigamox) treat your child’s bacterial conjunctivitis, it will over treat it!  Using Moxifloxacin (Vigamox) to treat common pink eye is like killing an ant with a rocket launcher.  Additionally, it is only available in brand name, so it can do some damage to your wallet.

Fluoroquinolone ophthalmic drops should be reserved for use only for patients that wear contacts.  For most kids suffering from pink eye, moxifloxacin (Vigamox) should not be used as first line treatment because it is expensive, unnecessary and common use can lead to bacterial resistance.

We usually treat bacterial conjunctivitis because it is uncomfortable, has a high gross factor, is super contagious and easily treatable.   However, the truth is, most kids don’t need to be treated and the pink eye will clear up within five days

Highly effective, inexpensive alternatives to the fluoroquinolone ophthalmic drops are erythromycin ointment (Ilocytin), sulfacetamide drops (Bleph-10) and polymixin/trimethoprim drops (Polytrim). The ointment is recommended in any patient that may be difficult to administer drops to –i.e. kids!  This is because the ointment stays on the lids and can help treat the pink eye even if it is doubtful that the medicine reached the actual conjunctiva.

Bottom line…the best primary treatment for bacterial pink eye is erythromycin ointment –an oldie but goodie!

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