What is the recommended management for non-severe conjunctivitis suspected to be bacterial?

• A. Topical antibiotic therapy such as erythromycin or trimethoprim-polymyxin B; supportive care.
• B. Oral antibiotics for 7 days.
• C. No treatment, watchful waiting only.
• D. Steroid eye drops alone.

Answer: (A)

For non-severe bacterial conjunctivitis, the best approach is topical antibiotic therapy paired with supportive care. Topical antibiotics such as erythromycin ointment or trimethoprim-polymyxin B drops deliver high concentrations directly to the eye, shorten the duration of symptoms, and reduce contagiousness with minimal systemic exposure. Supportive care includes lid hygiene and regular cleansing of discharge, plus avoiding contact lens use while symptoms persist. Oral antibiotics are unnecessary for a localized eye infection, steroid eye drops can mask or worsen infection, and watchful waiting alone is not preferred when a bacterial etiology is suspected.