Pediatric emergency medicine trisk 4051 4051
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TABLE 123.2
PEDIATRIC EMERGENCY DEPARTMENT OPHTHALMIC DRUG
GUIDELINES
Use
Avoid
Dilating drops
Phenylephrine 2.5%
Tropicamide 1%
Cyclopentolate 1%
Scopolamine
Atropine
Homatropine
Cyclopentolate 2%
Antibiotics
Bacitracin ointment
Neomycin
Erythromycin ointment
Sulfacetamide
Polysporin drops or ointment
Aminoglycosides (except
neonate)
Polytrim (trimethoprim/ polymyxin B) drops
Lubricants
Artificial tear drops or ointment
Vasoconstrictors/antihistamines
Naphazoline/antazoline
Diagnostic agents
Topical fluorescein
Anesthetic agents
Proparacaine, tetracaine
The ER clinicians should avoid the use/prescription of any of the following
without ophthalmology consultation:
ANTIVIRALS, MIOTICS, STEROIDS, a and ANTIGLAUCOMA AGENTS.
a Including
steroid-containing preparations, such as combination antibiotic-steroids.
There is no evidence to support the routine use of antimicrobials or antivirals in
the majority of viral conjunctivitis cases. Contrary to popular belief, “secondary
bacterial infection” is not a clinically significant problem in immunocompetent
children. Rather, these patients can be treated symptomatically with cool
compresses and over-the-counter lubricating agents (e.g., artificial tears) which
