Antibiotic Eye Drops: When Pink Eye Needs Them, US Options, Doses and Cost
Lokesh Maurya
Antibiotic Eye Drops: When Pink Eye Needs Them, US Options, Doses and Cost - pharmacy guide
In this article (23 sections)
Antibiotic eye drops treat infections of the eye surface caused by bacteria, most often bacterial conjunctivitis (bacterial pink eye). They do nothing for viral or allergic pink eye, and the AAO says most pink eye symptoms come from a virus. Drugs@FDA lists no over-the-counter antibiotic eye product, so in the US these are prescription medicines. This guide covers when an antibiotic is likely to help, the main US options with their label doses, what the trials on the labels and the latest Cochrane review show, the extra warnings on steroid and antibiotic combinations, contact lens rules, and what these drops cost.
For a map of every class of prescription eye drop, including glaucoma, dry eye and allergy drops, see our prescription eye drops guide. This page goes deeper on the antibiotics only.
Antibiotic eye drops at a glance
The table lists the US products whose labels we read for this guide, with the dose each label gives for bacterial conjunctivitis. All of them are prescription only.
| Drug (US example) | Class | Form | Label dose for bacterial conjunctivitis |
|---|---|---|---|
| Moxifloxacin 0.5% (Vigamox) | Fluoroquinolone | Drops, 3 mL | 1 drop 3 times a day for 7 days |
| Ofloxacin 0.3% (Ocuflox) | Fluoroquinolone | Drops, 5 mL | Days 1 and 2: 1 to 2 drops every 2 to 4 hours; days 3 to 7: 1 to 2 drops 4 times a day |
| Ciprofloxacin 0.3% | Fluoroquinolone | Drops, 2.5, 5 or 10 mL | 1 or 2 drops every 2 hours while awake for 2 days, then every 4 hours while awake for 5 days |
| Ciprofloxacin 0.3% ointment (Ciloxan) | Fluoroquinolone | Ointment, 3.5 g | Half inch ribbon 3 times a day for 2 days, then twice a day for 5 days |
| Gatifloxacin 0.5% (Zymaxid) | Fluoroquinolone | Drops, 2.5 mL | Day 1: 1 drop every 2 hours while awake, up to 8 times; days 2 to 7: 1 drop 2 to 4 times a day |
| Besifloxacin 0.6% (Besivance) | Fluoroquinolone | Suspension, 5 mL | 1 drop 3 times a day, 4 to 12 hours apart, for 7 days |
| Azithromycin 1% (AzaSite) | Macrolide | Drops, 2.5 mL | 1 drop twice a day for 2 days, then once a day for 5 days |
| Tobramycin 0.3% | Aminoglycoside | Drops, 5 mL | Mild to moderate: 1 or 2 drops every 4 hours |
| Gentamicin 0.3% | Aminoglycoside | Drops, 5 mL | 1 or 2 drops every 4 hours; up to 2 drops every hour in severe infections |
| Polymyxin B and trimethoprim | Combination | Drops, 10 mL | 1 drop every 3 hours (maximum 6 doses a day) for 7 to 10 days |
| Erythromycin 0.5% | Macrolide | Ointment, 3.5 g | About 1 cm ribbon up to 6 times a day |
Doses and bottle sizes come from the current US labels on DailyMed (sources at the end). Your prescriber may give a different schedule; follow the prescription.
Does pink eye need antibiotic eye drops?
Often it does not. The CDC clinical overview says most cases of acute infectious conjunctivitis in adults are viral and self-limited, and "do not require antimicrobial treatment." Its patient page says antibiotics "will NOT improve viral pink eye," and that mild bacterial pink eye "may get better without antibiotic treatment," usually clearing in 2 to 5 days, though it can take 2 weeks to go away completely.
When the cause is bacterial, the CDC says a doctor may prescribe an antibiotic, "usually given topically as eye drops or ointment," and that antibiotics may help shorten the infection, reduce complications and prevent spread to others. The American Academy of Ophthalmology (AAO) says doctors will appropriately prescribe antibiotics if pink eye is not getting better after 2 to 3 weeks, or if the patient is a baby younger than one month old.
Contact lens wearers are the clearest exception to waiting. The CDC says contact lens wearers with bacterial conjunctivitis are at higher risk of bacterial keratitis (infection of the cornea) and should remove their lenses, be treated with topical antibiotics, and be promptly evaluated by an ophthalmologist.
Bacterial, viral or allergic: why the cause matters
The CDC notes that the signs of bacterial conjunctivitis overlap with viral and allergic conjunctivitis, "which can make diagnosis difficult." The AAO patient page on antibiotic eye drops says the drops will not work for viral conjunctivitis, allergic conjunctivitis or fungal eye infections, and that bacterial infections commonly cause drainage of yellow-green pus.
| Type | What the CDC and AAO say | Does an antibiotic help? |
|---|---|---|
| Viral | Usually clears in 7 to 14 days without treatment; sometimes 2 to 3 weeks or more (CDC) | No |
| Bacterial, mild | Usually clears in 2 to 5 days without treatment; can take 2 weeks (CDC) | It may shorten the illness |
| Allergic | Not contagious; improves by removing the allergen; antihistamine drops help (CDC) | No |
| Herpes simplex or varicella zoster | Antiviral medicine may be used (CDC) | No, and steroid drops can make it worse |
The AAO also points to a study of nearly 45,000 children treated for pink eye in 2021: 69% were prescribed antibiotics, and return visits were under 4% whether or not they got one. Its spokesperson warns that unnecessary antibiotic drops can increase bacterial resistance. Our guide to antibiotic resistance explains why that matters beyond the eye.
What the Cochrane review found
The 2023 Cochrane review (Chen and colleagues, PMID 36912752) pooled randomized trials comparing antibiotics with placebo or vehicle in acute bacterial conjunctivitis. It included 21 trials and 8,805 participants; every treatment was a topical drop or ointment.
| Outcome | Result | Trials, people | Certainty |
|---|---|---|---|
| Clinical cure (intention to treat) | RR 1.26 (95% CI 1.09 to 1.46): 68.2% (504/739) on antibiotic vs 55.5% (408/735) on placebo by days 4 to 9 | 5 trials, 1,474 | Moderate |
| Microbiological cure (culture positive) | RR 1.53 (95% CI 1.34 to 1.74) | 10 trials, 2,827 | Not stated in abstract |
| Persistent clinical infection | RR 0.73 (95% CI 0.65 to 0.81), 27% less likely | 19 trials, 5,280 | Moderate |
| Not completing treatment | RR 0.64 (95% CI 0.52 to 0.78) | 13 trials, 5,573 | Moderate |
| Serious systemic side effects | No evidence of them in either group | Not stated | Very low |
Two points stand out. More than half of the placebo group got better on their own by days 4 to 9, which is why waiting is reasonable for mild cases. And antibiotics still raised the cure rate by about a quarter in relative terms. The review found no difference in clinical cure by antibiotic class, fluoroquinolone or not (P = 0.67), or by treatment length (P = 0.60). The newer fluoroquinolones were not shown to cure more people than older classes.
Fluoroquinolone drops: ofloxacin, ciprofloxacin and moxifloxacin
Fluoroquinolones are widely used antibiotic eye drops. Ofloxacin 0.3% and ciprofloxacin 0.3% are labeled for bacterial conjunctivitis and for corneal ulcers, with a much more intensive schedule for ulcers. Moxifloxacin 0.5% (Vigamox) is labeled for bacterial conjunctivitis only, at one drop three times a day for 7 days.
The Ocuflox and Vigamox labels are contraindicated in people with a history of hypersensitivity to the drug, "to other quinolones," or to any component. The ciprofloxacin label lists hypersensitivity to ciprofloxacin as a contraindication and says a history of hypersensitivity to other quinolones "may also contraindicate" its use. All three warn that serious and occasionally fatal allergic reactions, some after the first dose, have been reported with quinolones given by mouth or injection. The Ocuflox label also records a rare case of Stevens-Johnson syndrome progressing to toxic epidermal necrolysis in a patient using ofloxacin eye drops. Stop the drop and get help at the first sign of rash or allergic reaction.
The ciprofloxacin solution label describes a white crystalline precipitate on the cornea in 35 of 210 patients (16.6%) treated for corneal ulcers with frequent dosing. It did not stop treatment or harm the visual outcome.
Gatifloxacin and besifloxacin
Gatifloxacin 0.5% (Zymaxid) and besifloxacin 0.6% (Besivance, and now a generic suspension) are newer fluoroquinolones labeled for bacterial conjunctivitis. Gatifloxacin starts with a drop every 2 hours while awake on day 1 (up to 8 times), then 2 to 4 times a day for days 2 to 7. Besifloxacin is one drop three times a day for 7 days; the bottle is turned upside down and shaken once before each use.
The Zymaxid label is contraindicated with hypersensitivity to gatifloxacin or other quinolones, and reports hypersensitivity reactions including anaphylaxis "even following a single dose" of the eye drop, plus rare Stevens-Johnson syndrome. The besifloxacin label lists no contraindications. Its most common reaction was conjunctival redness, in about 2% of roughly 1,000 patients.
Azithromycin eye drops
Azithromycin 1% (AzaSite) is a macrolide drop labeled for bacterial conjunctivitis. Its schedule is short: one drop twice a day, 8 to 12 hours apart, for 2 days, then once a day for 5 days. The label says to store the unopened bottle in the refrigerator, and once opened to keep it at 2 to 25°C for up to 14 days and then discard it.
AzaSite is contraindicated only in hypersensitivity to any component. Its label notes that serious allergic reactions, including angioedema, anaphylaxis, Stevens-Johnson syndrome and toxic epidermal necrolysis, have been reported rarely with azithromycin taken by mouth or injection, and to consider that risk in anyone with a known azithromycin allergy. Eye irritation was the most common reaction, in about 1% to 2% of 698 patients. The label tells patients that feeling better early is common, but skipping doses or stopping early can reduce the effect and make resistance more likely. Drugs@FDA lists AzaSite solution as the only azithromycin product for the eye in the US; there is no US azithromycin eye ointment.
What the label trials show for each drop
Each of these labels reports its own trial, with different endpoints, days and patient groups. The numbers below should not be ranked against each other.
| Drug (label) | Trial design | Clinical result | Comparator |
|---|---|---|---|
| Besifloxacin 0.6% | Ages 1 to 98, 3 times a day for 5 days | Resolution 45% (90/198) | Vehicle 33% (63/191); difference 12%, 95% CI 3% to 22% |
| Gatifloxacin 0.5% (Zymaxid) | Two trials, ages 1 to 89, 5 days, culture positive | Success on day 6 58% (193/333) | Vehicle 45% (148/325) |
| Azithromycin 1% (AzaSite) | Twice daily 2 days, then once daily days 3 to 5 | Resolution on days 6 to 7 63% (82/130) | Vehicle 50% (74/149); difference 13%, 95% CI 2% to 25% |
| Ofloxacin 0.3% (Ocuflox) | Culture positive conjunctivitis | Clinical improvement after 2 days 86% (54/63) | Vehicle 72% (48/67) |
| Moxifloxacin 0.5% (Vigamox) | Two trials, 3 times a day for 4 days | Clinical cure on days 5 to 6 in 66% to 69% | Controlled trials; comparator rates not given |
| Ciprofloxacin 0.3% | 3 and 7 day trials, culture positive | Clinically cured 52%; 70% to 80% had all pathogens eradicated | Not given |
Read with the Cochrane result, the pattern is consistent: in each vehicle-controlled trial, many people on the vehicle also cleared, and the antibiotic added roughly 12 to 14 percentage points. The moxifloxacin and ciprofloxacin labels each report a clinical cure rate of 80% at day 9 in a trial of newborns up to 31 days old, in which the comparator was another antibiotic, not a vehicle.
Tobramycin and gentamicin drops
Tobramycin 0.3% and gentamicin 0.3% are aminoglycosides with broader labels than the newer drops. Tobramycin is indicated for "external infections of the eye and its adnexa caused by susceptible bacteria." Gentamicin's label lists conjunctivitis, keratitis, keratoconjunctivitis, corneal ulcers, blepharitis, blepharoconjunctivitis, acute meibomianitis and dacryocystitis.
Both are dosed every 4 hours, with up to hourly dosing in severe infection: the tobramycin label says 2 drops hourly until improvement, and the gentamicin label says the dose "may be increased to as much as two drops once every hour." The tobramycin label warns that sensitivity to topical aminoglycosides can range from local effects to anaphylaxis, and that cross-sensitivity to other aminoglycosides may occur. Its most frequent reactions, lid itching and swelling and conjunctival redness, occur in fewer than 3 of 100 patients. The gentamicin label notes that bacterial and fungal corneal ulcers have developed during treatment with gentamicin eye products, and tells patients to stop and see a doctor if discharge, inflammation or pain gets worse.
Polymyxin B and trimethoprim drops
Polymyxin B with trimethoprim is indicated for surface bacterial infections of the eye, "including acute bacterial conjunctivitis, and blepharoconjunctivitis." The dose is one drop every 3 hours, no more than 6 doses a day, for 7 to 10 days. It is one of the cheapest options in the US (see the cost section).
Its most frequent reaction is local irritation with redness, burning, stinging or itching. The label says it is "not indicated for the prophylaxis or treatment of ophthalmia neonatorum," and that safety and effectiveness below 2 months of age have not been established.
Antibiotic eye ointments: erythromycin, ciprofloxacin and others
Erythromycin 0.5% ointment is indicated for superficial infections of the conjunctiva and cornea, and for prevention of ophthalmia neonatorum due to N. gonorrhoeae or C. trachomatis. For infection, the label dose is a ribbon about 1 cm long up to six times a day. Ciprofloxacin 0.3% ointment (Ciloxan) uses a half inch ribbon three times a day for 2 days and twice a day for 5 days.
Drugs@FDA lists moxifloxacin for the eye only as solutions, and azithromycin only as the AzaSite solution. Moxifloxacin and azithromycin eye ointments, such as those made in India, have no US-approved counterpart.
Antibiotic eye drops for children and newborns
Age limits differ by label. Where a label says safety and effectiveness have not been established below an age, it means the trials did not cover that age, not that the drug is known to be harmful.
| Drug | What the US label says about age |
|---|---|
| Moxifloxacin (Vigamox) | Safety and effectiveness established in all ages, including neonates |
| Azithromycin (AzaSite) | Safety and effectiveness in pediatric patients established |
| Ofloxacin, gatifloxacin, besifloxacin | Not established below 1 year of age |
| Tobramycin; polymyxin B and trimethoprim | Not established below 2 months of age |
| Ciprofloxacin ointment (Ciloxan); tobramycin and dexamethasone | Not established below 2 years of age |
| Erythromycin ointment | Used for newborn eye prophylaxis; a new tube for each infant |
The AAO says a baby younger than one month with pink eye is one of the cases where doctors appropriately prescribe antibiotics. The CDC treatment page has its own section on newborns with pink eye under when to see a healthcare provider. A newborn's red eye should be seen in person, not treated from a home supply.
Steroid and antibiotic combination drops
Combination drops such as tobramycin 0.3% with dexamethasone 0.1% (TobraDex and generics) or 0.05% (TobraDex ST) are not simple antibiotic drops. The generic label's indication is "steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where superficial bacterial ocular infection or a risk of bacterial ocular infection exists." In other words, inflammation comes first.
The generic tobramycin and dexamethasone suspension is dosed at one or two drops every 4 to 6 hours, with up to every 2 hours in the first 24 to 48 hours. The label says not more than 20 mL should be prescribed initially, and the prescription should not be refilled without further evaluation. The TobraDex ST label adds that the first prescription and any renewal should be made only after examining the eye with magnification, such as a slit lamp.
Combination drop warnings: eye pressure, cataract and viral infection
- Contraindications. The tobramycin and dexamethasone label is contraindicated in epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella and "many other viral diseases of the cornea and conjunctiva," mycobacterial eye infection, fungal eye disease, and hypersensitivity to a component.
- Glaucoma. Prolonged steroid use may cause glaucoma with optic nerve damage. TobraDex ST says eye pressure should be monitored if the drop is used for 10 days or longer.
- Cataract. Steroids may cause posterior subcapsular cataract.
- Masking infection. In acute purulent conditions, steroids may mask infection or make it worse. TobraDex ST says the patient should be reevaluated if signs and symptoms fail to improve after 2 days.
- Thinning. In diseases that thin the cornea or sclera, perforations have occurred with topical steroids.
This is why a steroid and antibiotic drop is a poor choice for an undiagnosed red eye. If the cause is herpes, the steroid can make it worse. Our glaucoma eye drops guide explains why raised eye pressure matters.
Antibiotic eye drops and contact lenses
| Drug (label) | Contact lens instruction |
|---|---|
| Moxifloxacin (Vigamox) | Do not wear lenses with signs or symptoms of bacterial conjunctivitis |
| Azithromycin (AzaSite) | Same on the label; the patient leaflet adds: not "until you have finished your prescribed course of treatment" |
| Besifloxacin | No lenses with signs of bacterial conjunctivitis "or during the course of therapy" |
| Tobramycin; polymyxin B and trimethoprim | Do not wear lenses with signs and symptoms of bacterial eye infection |
| Ciprofloxacin solution | "Remove contact lenses before using" |
| Tobramycin and dexamethasone (generic and TobraDex ST) | Lenses "should not be worn during the use" of the product; TobraDex ST notes its preservative can be absorbed by soft lenses |
The CDC patient page gives the simplest rule: stop wearing contact lenses until your eye doctor says it is fine to restart, and if you did not see a doctor, do not wear them until the pink eye symptoms are gone.
Side effects of antibiotic eye drops
Most side effects are local and short-lived. The labels report:
- Moxifloxacin: conjunctivitis, reduced visual acuity, dry eye, keratitis, discomfort, redness, pain, itching, small bleeds under the conjunctiva and tearing, each in about 1% to 6% of patients.
- Besifloxacin: conjunctival redness about 2%; blurred vision, eye pain, irritation, itching and headache about 1% to 2%.
- Gatifloxacin: worsening conjunctivitis, eye irritation, taste change and eye pain, each in at least 1% of 717 patients.
- Ofloxacin and ciprofloxacin: transient burning or discomfort was the most frequent; ciprofloxacin also lists a bad taste after instillation.
- Tobramycin: lid itching and swelling and conjunctival redness in fewer than 3 in 100.
- Erythromycin ointment: minor irritation, redness and hypersensitivity reactions.
The AAO adds that many antibiotic drops contain preservatives that can cause keratopathy (surface damage to the cornea). The fluoroquinolone, azithromycin and gatifloxacin labels all warn that prolonged use may lead to overgrowth of organisms that do not respond, including fungi.
Is there an over the counter antibiotic eye drop?
Not in the US. The over-the-counter eye drugs listed in Drugs@FDA are allergy and redness drops such as ketotifen (Alaway, Zaditor), olopatadine (Pataday), alcaftadine (Lastacaft), brimonidine (Lumify) and naphazoline with pheniramine (Naphcon-A, Visine). None is an antibiotic.
For relief while you wait, the CDC suggests cold compresses and artificial tears, both available without a prescription. If the eye is getting worse, painful or affecting vision, see a clinician rather than looking for a stronger drop.
Chloramphenicol eye drops and the US
Chloramphenicol is the active ingredient in two products we list. In the US it is not marketed for the eye: every chloramphenicol eye product in Drugs@FDA, including Chloroptic drops and Chloromyxin (chloramphenicol with polymyxin B) ointment, is listed as discontinued. A chloramphenicol eye product bought abroad therefore has no current US-approved equivalent, which matters for importing (see below).
What antibiotic eye drops cost in the US
NADAC (National Average Drug Acquisition Cost) is what US retail pharmacies paid for a drug, from a CMS monthly survey updated weekly. It is not the price at the counter, which adds a dispensing fee and margin or depends on insurance. NADAC prices eye drops per mL and ointments per gram, so we multiplied by the package size on the US label. All figures are the 28 October 2026 medians.
| Product (US package) | Type | NADAC per mL or g | Per bottle or tube |
|---|---|---|---|
| Polymyxin B and trimethoprim (10 mL) | Generic | $0.45072 | $4.51 |
| Gentamicin 0.3% (5 mL) | Generic | $0.90734 | $4.54 |
| Moxifloxacin 0.5% (3 mL) | Generic | $1.66499 | $4.99 |
| Tobramycin 0.3% (5 mL) | Generic | $1.09593 | $5.48 |
| Ofloxacin 0.3% (5 mL) | Generic | $1.22968 | $6.15 |
| Ciprofloxacin 0.3% (5 mL) | Generic | $1.47777 | $7.39 |
| Erythromycin 0.5% ointment (3.5 g) | Generic | $4.83328 | $16.92 |
| Tobramycin and dexamethasone (5 mL) | Generic | $4.28732 | $21.44 |
| Gatifloxacin 0.5% (2.5 mL) | Generic | $9.46564 | $23.66 |
| Vigamox (3 mL) | Brand | $31.80800 | $95.42 |
| Besifloxacin 0.6% (5 mL) | Generic, first seen 21 October 2026 | $33.67760 | $168.39 |
| Besivance (5 mL) | Brand | $44.10026 | $220.50 |
| TobraDex ST (5 mL) | Brand | $46.62789 | $233.14 |
| AzaSite (2.5 mL) | Brand | $98.39291 | $245.98 |
| Ciloxan ointment (3.5 g) | Brand | $74.35792 | $260.25 |
The older generic drops cost US pharmacies under $8 a bottle. The large costs sit with brands and the newest molecules: Drugs@FDA shows only a tentative approval for a generic azithromycin eye solution, and the new generic besifloxacin still cost pharmacies $168.39 a bottle. If you have been prescribed an expensive brand for routine pink eye, it is reasonable to ask whether an older generic would do.
Antibiotic eye products we stock and their prices
These are the Indian-made products we list, with prices from our product database as of 31 October 2026. "Per unit" is the smallest pack price divided by the number of bottles or tubes. Larger packs cost less per unit. Pack sizes are as shown on each product page; Indian packs often differ from US ones.
| Product | Active ingredients (as listed) | Size | Smallest pack | Per unit |
|---|---|---|---|---|
| Oflox | Ofloxacin 0.3% | See product page | 3 for $5.00 | $1.67 |
| Toba | Tobramycin | 5 mL | 3 for $13.00 | $4.33 |
| Besix | Besifloxacin | 5 mL | 1 for $8.00 | $8.00 |
| Zaha | Azithromycin | 3 mL | 3 for $13.00 | $4.33 |
| Mosi eye ointment | Moxifloxacin | 5 g | 1 for $5.00 | $5.00 |
| Azithral eye ointment | Azithromycin 1% | 5 g | 1 for $10.00 | $10.00 |
| Zoxan ointment | Ciprofloxacin 0.3% | See product page | 3 for $7.00 | $2.33 |
| Ocupol eye ointment | Chloramphenicol and polymyxin B | 5 g | 1 for $6.00 | $6.00 |
| Chlorocol | Chloramphenicol | 10 mL | 3 for $10.00 | $3.33 |
| Toba DM | Tobramycin and dexamethasone (steroid) | 10 mL | 3 for $8.00 | $2.67 |
| Toba F | Tobramycin 0.3% and fluorometholone 0.1% (steroid) | 5 mL | 3 for $20.00 | $6.67 |
| Oflox-D | Ofloxacin 0.3% and dexamethasone 0.1% (steroid) | See product page | 3 for $10.00 | $3.33 |
| Ciplox D eye/ear drop | Ciprofloxacin and dexamethasone (steroid) | 10 mL | 3 for $13.00 | $4.33 |
| Zoxan D eye/ear drop | Ciprofloxacin and dexamethasone (steroid) | 5 mL | 3 for $13.00 | $4.33 |
On cost alone, our plain antibiotic drops are close to what US pharmacies pay for the older generics: Oflox works out at $1.67 a bottle against a $6.15 NADAC for US generic ofloxacin, and Toba at $4.33 against $5.48 for tobramycin. A US pharmacy with insurance may still cost you less. The gap is large only for the newer molecules: Besix is $8.00 a 5 mL bottle against $168.39 for 5 mL of US generic besifloxacin 0.6%, and Zaha is $4.33 a 3 mL bottle against $245.98 for a 2.5 mL bottle of AzaSite 1%. Our listings for Besix and Zaha do not state the strength, so check the carton; we do not assume they are equivalent to the US products.
Five products in the table contain a steroid. As the warnings above explain, they are for inflammation with infection or infection risk, after an eye exam, and they are the wrong choice for a red eye of unknown cause. Drugs@FDA lists ciprofloxacin with dexamethasone in the US only as ear drops (Ciprodex and generics), not for the eye, and lists no ofloxacin and dexamethasone product. The chloramphenicol products have no current US-approved equivalent.
Importing antibiotic eye drops into the US
The FDA's personal importation page says: "In most circumstances, it is illegal for individuals to import drugs or devices into the U.S. for personal use because these products purchased from other countries often have not been approved by the FDA for use and sale in the U.S. If a drug is approved for use in another country but is an unapproved new drug in the U.S. it is illegal to import." It adds that the FDA cannot vouch for the safety and effectiveness of medicine bought over the Internet from foreign sources, and it recommends "only obtaining medicines from legal sources in the U.S." The page also describes situations in which FDA staff may take a more permissive decision for personal use.
Read the FDA personal importation page in full and check your own situation before ordering. We do not claim that importing any of these products is permitted. For checking a seller and following eye drop recalls, see our eye drops recall list.
How to use antibiotic eye drops and ointment
- Keep the tip clean. The labels tell patients not to let the dropper or tube tip touch the eye, fingers or any surface. A contaminated bottle can carry bacteria into the eye.
- Shake when the label says so. Besifloxacin and AzaSite are turned upside down and shaken once before each use.
- Finish the course. The AAO says to take all of the medication and not stop early, even if things seem better, and not to keep leftover drops for later or use anyone else's prescription.
- Blurred vision. TobraDex ST warns that vision may be temporarily blurred after dosing and to take care driving or operating machinery.
- Store as labeled. Most of these are stored at room temperature; unopened AzaSite goes in the refrigerator and is discarded 14 days after opening.
If you also use long-term drops, such as cyclosporine for dry eye or a glaucoma drop, ask your prescriber whether to pause them during the infection.
When to see a doctor about an eye infection
The AAO says antibiotic eye drops usually improve symptoms within 3 days, and to call your doctor if symptoms do not go away. It also advises an appointment with an ophthalmologist if red eye symptoms continue after 2 to 3 weeks. Seek care promptly for:
- Symptoms the AAO lists for eye infection: pain, swollen eyes, redness, light sensitivity, or yellow-green pus. Its advice is to see a doctor if you think you have any eye infection.
- Any red, sticky eye in a contact lens wearer (CDC: risk of bacterial keratitis).
- A newborn or baby under one month with pink eye.
- No improvement after 2 days on a steroid and antibiotic drop (TobraDex ST label).
- Worsening discharge, inflammation or pain on treatment (gentamicin label).
- A rash, swelling or breathing trouble after starting a drop; stop it and get emergency help.
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