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DRUG name (generic and common): Trimethoprim Polymyxin B Polymyxin B and trimethoprim are combined in an ophthalmic preparation for the treatment of acute bacterial ocular infections  interferes with folate synthesis in susceptible bacteria  blocks the production of tetrahydrofolic acid from  binds to phospholipids in the gram-negative bacterial cell  This binding destroys bacterial membranes with a surface detergent-like mechanism and increases the permeability of the cell membrane, which results in loss of metabolites essential to bacterial existence  Polymyxin B is bactericidal against most gram-negative bacilli; however, some Proteus and Serratia species may be resistant Polymyxin B and trimethoprim combinations are applied In patients hypersensitive to any of the components of the product (e.g., patients with polymyxin hypersensitivity or trimethoprim hypersensitivity). If a hypersensitivity reaction occurs, discontinue use of the product. Common: irritation, increased redness, lid edema, burning, stinging and/or itching. Rare: photosensitivity For the treatment of ocular infections, including bacterial conjunctivitis and blepharoconjunctivitis, caused by susceptible strains of bacteria 1mg/mL Trimethoprim 10,000u/mL Polymyxin B 1-2 drops in affected eye every 4-6hours Max=12 perday Course is 7-10 days Regimen in combination with erythromycin Sources: DRUG name (generic and common): Erythromycin Erythromycin is a macrolide antibiotic produced by Streptomyces erythraeus and was the first of several macrolide antibiotics now on the market. Although erythromycin is active against many microbes, its clinical applications are relatively few. It is an alternative to beta-lactam antibiotics in patients who are allergic Erythromycin binds to the 50 S ribosomal subunit, inhibiting bacterial protein synthesis. Better against gram-positive organisms greater gram-negative organisms Gram-positive organisms: Staphylococcus aureus, Streptococcus agalactiae, S. pyogenes, S. pneumoniae, S. viridians In general, erythromycin should not be used against Haemophilus influenzae, although in some cases this organism may be susceptible. Gram-negative organisms: Chlamydia monocytogenes, Borrelia burgdorferi (causative agent of Lyme disease), Mycoplasma pneumoniae, Erythromycin is administered orally, intravenously, topically, and Hypersensitivity to erythromycin or other macrolides. (azythromycin aka Zythromax, clarythromycin) Eye ointments usually cause vision to blur for a few minutes following application. Therefore it is suggested for use at bedtime Erythromycin ophthalmic ointment may cause local irritation and hypersensitivity reactions have been reported. Contact lenses should not be worn for the duration of therapy First-line therapy for treatment of bacterial conjunctivitis Apply 1cm ribbon to the affected eye(s) at night 7-10 days Second Line: ciproflaxin- Organisms that are resistant to beta lactams or aminoglycosides may be susceptible to these. It inhibits relaxation of supercoiled DNA and promotes breakage of double-stranded DNA. Third Line: Gentamicin - Inhibits bacterial protein synthesis by inhibiting 30S ribosomal subunit and causing cell membrane damage. Sources:

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