Eye

Most cases of acute bacterial conjunctivitis are self-limiting and resolve without antibiotic treatment

Cases where antibiotics are required (e.g. severe, not resolved spontaneously after 5 days)

Chloramphenicol 0.5% eye dropsdose or 1% ointmentdose (available via pharmacy first)

Duration: Continue use until 48 hours after infection has cleared. 

Orbital cellulitis & peri-orbital cellulitis (moderate/severe)

This is a medical emergency requiring urgent hospital admission and advice from ophthalmology

Peri-orbital cellulitis (Mild / Uncomplicated)

Children:

Refer to: Hospital: Paediatrics (Skin and Soft tissue, Peri-orbital cellulitis / Orbital cellulitis)

Adults:

Co-amoxiclav dose

Penicillin Allergy or Known MRSA: Doxycycline dose + metronidazole dose (Pregnant: Clarithromycin ^*,dose + metronidazole dose)

* Review previous microbiology results. If colonised with clarithromycin-resistant MRSA, seek advice from Consultant Microbiologist for alternative agent.

Duration: 5 - 7 days

Signs OR symptoms of eye involvement: refer to ophthalmology and/or admit to hospital

Start treatment up to 7 days after onset of rash.

Aciclovir dose

Add lubricating eye drops if lesions near eyelidDuration: 7 days