The Scenario of V.S a 12 year old Hispanic Male with Injected Conjunctiva
V.S., age 12 Hispanic male, presents with a feeling that there is sand in his eye. He had a cold a week ago and woke up this morning with his left eye crusted with yellowish drainage. On physical examination, he has injected conjunctiva on the left side, no adenopathy, and no vision changes. His vision is 20/20. Fluorescein staining reveals no abrasion. He is allergic to sulfa.
- List specific goals of treatment for V.S. who is diagnosed with injected conjunctiva
- What drug therapy would you prescribe? Why?
- What are the parameters for monitoring the success of the therapy?
- Discuss the education you would give to the parents regarding drug therapy.
- List one or two adverse reactions for the selected agent that would cause you to change therapy.
- What would be the choice for second-line therapy?
- What over-the-counter or alternative medications would be appropriate for V.S.?
- What dietary and lifestyle changes should be recommended for V.S.?
- Describe one or two drug–drug or drug–food interactions for the selected agent.
Read also Eye Infections Research Paper
Goals of Treatment for Patient Diagnosed with Injected Conjunctiva
The acute bout of conjunctivitis evident from the presenting patient was likely the direct result of either a bacterial or viral conjunctivitis infection. It, therefore, becomes fundamental to set clear and elaborate treatment goals to ensure the patient recovers fully from the disease within no time
The main initial goal of treatment for the patient is to relieve the presenting symptoms in order to alleviate irritation and to eventually enable him to lead a normal high-quality life. Moreover, another critical objective in treating V. S’s conjunctivitis is to reduce the course of viral or bacterial infection known to induce inflammation among patients. Achieving each of the above-mentioned treatment goals would eventually prove noble and critical to community and public health since treatment essentially prevents further spread this contagious disease among the general population.
First-Line Drug Therapy Prescribed to Treat Conjunctivitis
Broad spectrum antibiotics have long been recommended as an ideal treatment option for patients diagnosed with conjunctivitis. Personally, I would prescribe Levofloxacin as the most appropriate broad-spectrum antibiotic to treat the patient’s microbial infection. Levofloxacin is a first-line antibiotic drug therapy option commonly prescribed to treat bacterial and viral infections such as conjunctivitis and with a low microbial resistance profile (Sheikh & Hurwitz, 2006). Timely intervention is necessary to ensure the disease duration is shortened significantly given that one of its main goals is to prevent further infection. Levofloxacin will also be beneficial in managing and eliminating the copious purulent discharge due to its efficacy in eliminating inflammation. However, regular follow-up sessions remain crucial during recovery and as a measure of the overall efficiency of the prescribed medication.
Parameters for Monitoring Success of Levofloxacin Antibiotic Therapy for Conjunctivitis
Several wide-ranging parameters can be applied in determining the overall success or failure of Levofloxacin therapy in treating conjunctivitis. Successful treatment with the drug would typically result in a drastic reduction in patient’s irritation and reddening of what is commonly referred to as the white of the eye (Jones, 2014). Another important parameter to consider is a substantial and noteworthy reduction in swelling within the conjunctiva or eyelids in response to a broad-spectrum antibiotic therapy with Levofloxacin. Moreover, the success of Levofloxacin therapy can also be gauged based exclusively on the complete elimination of the copious purulent discharge, crusting eyelids returning to normal and an end to the burning sensation.
Patient Education Regimen Regarding Levofloxacin Antibiotic Therapy for Injected Conjunctiva
Today, patient education remains one of the most fundamental activities during treatment.
J et al., (2020) argue that the idea behind patient education is the literal arming of patients with a myriad of relevant medical data directly related to their recent diagnosis and accompanying steps to be followed in order to improve patient outcomes. In this particular case, I would begin my patient education regimen on Levofloxacin Antibiotic Therapy by reminding the patient of the importance of adherence to the treatment plan based on the recommended medication dosage. V.S. will be expected to apply the ophthalmic solution every two hours during the day. However, it will also be important to remind the patient not to apply the drops more than 8 times in a day. The patient should also keep the medicine in a germ-free secure location away from children. In case of a missed dose, the patient should proceed to take the medicine as soon as possible to prevent bacterial colonies from recovering and thriving.
Possible Adverse Reactions to Levofloxacin Antibiotic Therapy in the Treatment of Conjunctivitis
Typically, patients newly diagnosed with conjunctivitis have a duty to tell the prescribing clinical staff whether they are allergic to broad spectrum antibiotics such as Levofloxacin, Ofloxacin, Gemifloxacin, or Quinolone. This is a precautionary measure taken to prevent scenarios where patients suffer severe allergic reactions once exposed to Levofloxacin or ingredients used in its preparation. However, adverse reactions to pharmacological agents is a common fixture during therapy with broad spectrum antibiotics. For instance, an adverse reaction to Levofloxacin antibiotic therapy in the treatment of conjunctivitis may manifest as nausea, diarrhea, heartburn or vomiting (Baum & Barza, 2021). Nevertheless, patients should always remember to consult their primary healthcare provider for professional guidance if the adverse reactions persist.
Avelox as an ideal Second-Line Antibiotic Therapy Option in Treating Injected Conjunctiva
Avelox is a suitable second-line antibiotic therapy option approved by the U.S Food and Drugs Administration (FDA) and is appropriate for treating patients suffering from conjunctivitis. It is of the fluoroquinolones class of broad-spectrum antibiotics and is mainly administered as an injection or in the form of Maxifloxacin Hydro-chloride tablets. However, it is important to point out that the Levofloxacin must first be proved to be ineffective in treating conjunctivitis before resorting to prescribing a second-line antibiotic therapy option. Avelox is a strong broad-spectrum antibiotic with a potential to cause serious side effects which may very well result in death. However, if prescribed, the patient should take the film coated Avelox 400 mg tablets, orally daily, until the final clearing of the bacterial infection.
Over-the-Counter Medications and Alternative Medicine Appropriate for Treating Conjunctivitis
It is fundamental to begin by pointing out that that OTC medications and alternative medicines are largely incapable of treating any common case of viral or bacterial conjunctivitis. Nevertheless, they play an outstanding role in helping patients to cope by helping to alleviate the symptoms. Artificial tears are an example of OTC medication which can play an important role in preventing ocular dryness and inflammation (Nwaele & Satre, 2013). Antihistamines are also a dependable OTC capable of preventing irritation by blocking allergy-causing histamines. A similar effect is also observed with decongestants and vasoconstrictors since they prevent the widening of blood vessels during a histamine-triggered allergic reaction.
Dietary and Lifestyle Changes Recommended for VS
The journey to recovery after suffering from conjunctivitis not only requires pharmacological intervention but also relies on a complete overhaul of diet and lifestyle patterns. A diet consisting of leafy vegetables, fruits, Vitamin A (eggs and dairy products), Vitamin B2 and Zinc are critical in preventing conjuctvitis and in promoting optimal eye health (Sheikh & Hurwitz, 2017). However, VS must remember to avoid the excessive intake of starch and sugary foods known to cause a condition known as catarrhal which is known to signal the possible development of conjunctivitis. VS must also make major lifestyle changes such as avoiding a sedentary lifestyle and trading it for physical activities such as regular exercise and wellness routines such as Yoga.
Drug-Drug and Drug-Food Interactions when taking Levofloxacin
- Chelation Agents: Levofloxacin interacts with chelation agents, such as antacids and multivitamins, and may hinder gastrointestinal movement.
- Warfarin: Levofloxacin is also known to interact with Warfin; causing a post-marketing effect characterized by the enhancing of its effects and elevations in prothrombin time.
- Dairy Products: Patients taking Levofloxacin should avoid dairy products such as cheese, yogurt, and milk 2 hours before and after taking the medication to minimize the chances of an adverse reaction or possible side effects (Iacobucci, 2016).
- Multi-Vitamins Containing Mineral Supplements: Multi-Vitamins with active components consisting of a mineral supplement base should be avoided when a patient is on Levofloxacin since it may hinder the process involved in its absorption to the blood thus reducing its general efficacy.