Table 3

First and second line broad spectrum therapy

First line:
Suspected pathogen:
 BacteriaGentamicin 1.5% + cefuroxime 5%a,b or ciprofloxacin or ofloxacin 0.3% as monotherapy 36 37
 FungiAmphotericin 0.1% or natamycin 5%
 AmoebaeChlorhexidine 0.02% + propamidine 0.1%
Second line:
Suspected pathogen:
 Fastidious bacteriaAmikacin 2.5% + vancomycin 5% + Polytrim or ciprofloxacin 0.3%
 FungiAmphotericin 0.1% or natamycin 5%
 AmoebaeChlorhexidine 0.02% + propamidine 0.1%

  • S pneumoniae, use penicillin 0.3% instead.

  • Ps aeruginosa, add ticarcillin 5% or ceftazidime 5% or ciprofloxacin 0.3%.

  • ↵Ciprofloxacin 0.3% and ofloxacin 0.3% are commercially available in UK.

  • ↵Natamycin is not commercially available in UK.

  • Withhold steroids unless already in use before presentation.