Conjunctivitis (Infants, Children, Adolescents)

Patient Population: Pediatric

See Ophthalmia Neonatorum section for special considerations in neonates.  

Condition Major Pathogens  First Choice Therapy Alternative Therapy Comments


This section does not address infectious keratitis associated with contact lens wear (patients with this condition should be managed in consultation with an optometrist or ophthalmologist) 

Often viral 

Streptococcus pneumoniae 

Haemophilus influenzae 

Moraxella catarrhalis 

Staphylococcus aureus 

Supportive care without topical antibiotic therapy is recommended unless bacterial etiology is suspected based on clinical features 

If suspected bacterial etiology

Trimethoprim-Polymyxin B (Polytrim) 0.1%-10,000 units/ml ophthalmic drops 1-2 drops 4 times daily  

Topical therapy is not necessary if patient is on concurrent systemic therapy with coverage against likely causative organisms 

Commonly caused by viruses, consider supportive treatment such as warm compresses or cold saline drops 

Duration: 5-7 days 

Pediatric Empiric Antimicrobial Therapy Guidelines

This is a subsection of the UCSF Benioff Children’s Hospitals Empiric Antimicrobial Therapy Guidelines, developed by the Pediatric Antimicrobial Stewardship Programs at each campus to inform initial selection of empiric antimicrobial therapy for children at the UCSF Benioff Children’s Hospitals and affiliated outpatient sites. 

These are guidelines only and not intended to replace clinical judgment. Modification of therapy may be indicated based on patient comorbidities, previous antibiotic therapy or infection history. Doses provided are usual doses but may require modification based on patient age or comorbid conditions. Refer to Pediatric Antimicrobial Dosing Guideline for further guidance on dosing in children, and Neonatal Dosing Guideline for infants < 1 month of age. Consult a pediatric pharmacist for individualized renal or hepatic dose adjustment. Durations provided are usual recommendations for patients who are responding appropriately to therapy. For additional guidance, please contact Pediatric Infectious Diseases (ID) or the Pediatric Antimicrobial Stewardship Program (ASP) at the campus where your patient is receiving care.  

For questions or feedback about these guidelines, please email primary content owners, Rachel Wattier, Pediatric ASP Medical Director at BCH SF and Prachi Singh, Pediatric ASP Medical Director at BCH OAK. 

The content of these guidelines was updated in July 2021. See Summary and Rationale for Changes (password login to Box needed) for detailed explanations of the content changes.