Management of Antibiotic Eye Drop Reactions

Alternative Antibiotic Options

• Fluoroquinolone eye drops, such as ciprofloxacin or moxifloxacin, are safe alternatives for patients with penicillin allergy, with no cross-reactivity with penicillins 1, 2
• Aminoglycoside eye drops, such as gentamicin or tobramycin, can be used in patients with penicillin allergy, with no cross-reactivity concerns 2
• Erythromycin ophthalmic ointment is another option for patients with penicillin allergy, with no beta-lactam cross-reactivity 2

Important Considerations for Future Antibiotic Needs

• Carbapenems have a low cross-reactivity rate of 0.87% with penicillins and can be used without prior allergy testing in patients with penicillin allergy 3, 2
• Cephalosporins with dissimilar side chains to penicillins have a low cross-reactivity rate of 2.11% 2
• Aztreonam can be safely administered to patients with penicillin allergy 2

Follow-up Recommendations

• Consider referral to an allergist if the reaction to Polysporin eye drops was severe or if clarification of the patient's penicillin allergy status would benefit future antibiotic selection, as recommended by the British Journal of Anaesthesia 4