BNF for Children 2011-2012

520 11.3.2 Antifungals BNFC 2011–201211 EyeLEVOFLOXACINPregnancy manufacturer advises avoid—systemicquinolones have caused arthropathy in animal studiesBreast-feeding manufacturer advises avoidSide-effects transient ocular irritation, visual disturbances,lid margin crusting, lid or conjunctivaloedema, hyperaemia, conjunctival follicles, photophobia,headache, rhinitisLicensed use not licensed for use in children under 1yearIndication and doseSee notes aboveOftaquix c (Kestrel Ophthalmics) TAEye drops, levofloxacin 0.5%, net price 5 mL = £6.95MOXIFLOXACINCautions not recommended for neonatesSide-effects taste disturbances, ocular discomfort(including pain, irritation and dryness), hyperaemia;less commonly vomiting, headache, paraesthesia,corneal disorders (including keratitis, erosion, andstaining), conjunctival haemorrhage, eyelid erythema,visual disturbances, nasal discomfort, pharyngolaryngealpain; also reported nausea, palpitation, dyspnoea,dizziness, raised intra-ocular pressure, photophobia,rash, pruritusIndication and doseLocal treatment of infections (see also notesabove)Child 1 month–18 years apply 3 times daily(continue treatment for 2–3 days after infectionimproves; review if no improvement within 5 days)Moxivig c (Alcon) TAEye drops, moxifloxacin (as hydrochloride) 0.5%. Netprice 5 mL = £9.80NEOMYCIN SULPHATEIndication and doseSee notes aboveNeomycin (Non-proprietary) AEye drops, neomycin sulphate 0.5% (3500 units/mL).Net price 10 mL = £3.11Available from ‘special-order’ manufacturers or specialistimporting companies, see p. 809Eye ointment, neomycin sulphate 0.5% (3500 units/g). Net price 3 g = £2.44Available from ‘special-order’ manufacturers or specialistimporting companies, see p. 809OFLOXACINCautions not to be used for more than 10 daysPregnancy manufacturer advises use only if benefitoutweighs risk; systemic quinolones have causedarthropathy in animal studiesBreast-feeding manufacturer advises avoidSide-effects local irritation including photophobia;dizziness, numbness, nausea and headache reportedLicensed use not licensed for use in neonatesIndication and doseLocal treatment of infections (see also notesabove)Apply every two to four hours for the first two daysthen reduce frequency to four times daily (max. 10days treatment)Exocin c (Allergan) AOphthalmic solution (= eye drops), ofloxacin 0.3%.Net price 5 mL = £2.17Excipients include benzalkonium chloridePOLYMYXIN B SULPHATEIndication and doseSee notes aboveWith other antibacterialsPolyfax c (TEVA UK) AEye ointment, polymyxin B sulphate 10 000 units,bacitracin zinc 500 units/g. Net price 4 g = £3.26PROPAMIDINE ISETIONATEIndication and doseSee under preparations belowBrolene c (Sanofi-Aventis)Eye drops, propamidine isetionate 0.1%. Net price10 mL = £2.80Excipients include benzalkonium chlorideDoseLocal treatment of infections (but see notes above)Apply 4 times dailyNote Eye drops containing propamidine isetionate 0.1% alsoavailable from Typharm (Golden Eye Drops)Eye ointment, dibrompropamidine isetionate 0.15%.Net price 5 g = £2.92DoseLocal treatment of infections (but see notes above)Apply 1–2 times dailyNote Eye ointment containing dibrompropamidine isetionate0.15% also available from Typharm (Golden Eye Ointment)TOBRAMYCINIndication and doseLocal treatment of infections (see also notesabove)Child 1–18 years apply twice daily for 6–8 days;in severe infection, apply 4 times daily on the firstday, then twice daily for 5–7 daysTobravisc c (Alcon) AEye drops, tobramycin 0.3%, net price 5 mL = £4.74Excipients include benzododecinium bromide11.3.2 AntifungalsFungal infections of the cornea are rare. Orbital mycosisis rarer, and when it occurs it is usually because of directspread of infection from the paranasal sinuses. Debilityor immunosuppression can encourage fungal proliferation.The spread of infection through blood occasionallyproduces metastatic endophthalmitis.