What is the first-line treatment for bacterial conjunctivitis in patients who do not wear contacts?

The first-line treatment for bacterial conjunctivitis in patients who do not wear contact lenses is topical erythromycin. This antibiotic works effectively against the common pathogens responsible for bacterial conjunctivitis, such as Staphylococcus aureus and Streptococcus pneumoniae. Erythromycin is preferred due to its safety profile, effectiveness, and ease of use.

In cases of bacterial conjunctivitis not associated with contact lens use, monitoring often shows that patients do not require more aggressive treatments, such as fluoroquinolone drops like ciprofloxacin, which are typically reserved for more severe infections or in cases where there is a risk of Pseudomonas aeruginosa, particularly in contact lens wearers. Oral antibiotics are not typically indicated for uncomplicated cases of conjunctivitis, as local topical treatment is sufficient. Warm compresses may provide symptomatic relief but do not address the underlying infection.

Thus, the selection of topical erythromycin as the first-line treatment aligns well with both clinical guidelines and the nature of common bacterial conjunctivitis in this patient population.