Bacterial Conjunctivitis: Selection of Effective Antimicrobial Agents
DOI: 10.32364/2311-7729-2026-26-2-5
Bacterial Conjunctivitis: Selection of Effective Antimicrobial Agents
G.A. Azamatova1,2, G.Ya. Gaysina1,3, M.T. Aznabaev1, M.M. Tuigunov1, G.S. Sabitova1
1Bashkir State Medical University, Ufa, Russian Federation
2Ufa Branch of Bud Zdorov Clinic LLC, Ufa, Russian Federation
3Medical Plus LLC, Ufa, Russian Federation
Background: infectious conjunctivitis represents one of the most prevalent inflammatory ocular conditions encountered in ophthalmic practice, with bacterial forms accounting for a substantial proportion of cases. At present, the selection of an appropriate therapeutic agent is often challenging due to the increasing prevalence of bacterial antimicrobial resistance.
Aim: to analyze the etiological spectrum of bacterial conjunctivitis and the antibiotic susceptibility of causative pathogens in order to establish a rational approach to empirical antimicrobial therapy.
Materials and Methods: a microbiological study was conducted to identify the most common causative agents of bacterial conjunctivitis and to determine their susceptibility to antibiotics commonly used in ophthalmic practice. Microorganism identification was performed using matrix-assisted laser desorption/ionization mass spectrometry. Antibiotic susceptibility testing was carried out on blood agar using the disk diffusion method in accordance with current clinical guidelines. To illustrate the selection of antimicrobial therapy in infectious conjunctivitis, representative clinical cases from the authors' practice are provided.
Results: positive microbial growth was detected in 54 cases (90.0%), yielding 70 microbial strains. Mixed infections involving two microorganisms were identified in 10 patients (16.7%). Etiological analysis demonstrated a predominance of Gram-positive flora, with Staphylococcus epidermidis and Staphylococcus aureus being the most frequently isolated pathogens. Among the tested agents, later-generation fluoroquinolones — particularly moxifloxacin and levofloxacin — exhibited the highest antibacterial activity. The authors' clinical experience with empirical therapy further supports the high efficacy of topical moxifloxacin 0.5% and benzyl-dimethyl-myristoylamino-propylammonium 0.01%.
Conclusion: modern fluoroquinolones may be considered first-line agents for the empirical treatment of bacterial conjunctivitis, given their high activity against commonly isolated pathogens.
Keywords: infectious conjunctivitis, bacterial conjunctivitis treatment, antimicrobial susceptibility, fluoroquinolones, moxifloxacin, Okomistin.
About the authors:
Gulnara A. Azamatova — C. Sc. (Med.), Associate Professor, Associate Professor of the Department of Ophthalmology, Bashkir State Medical University; 3, Lenina str., Ufa, 450008, Russian Federation; Ophthalmologist, Ufa Branch of Bud Zdorov Clinic LLC; 6/1, prospekt Oktyabrya, Ufa, 450001, Russian Federation; ORCID iD 0000-0001-8158-8333
Gulfiya Ya. Gaysina — C. Sc. (Med.), Associate Professor of the Department of Ophthalmology, Bashkir State Medical University; 3, Lenina str., Ufa, 450008, Russian Federation; Ophthalmologist, Medical Plus LLC; 20, Borodinskaya str., Ufa, 450074, Russian Federation; ORCID iD 0000-0002-6372-5290
Marat T. Aznabaev — Dr. Sc. (Med.), Professor, Academician of the Academy of Sciences of the Republic of Bashkortostan, Professor of the Department of Ophthalmology, Bashkir State Medical University; 3, Lenina str., Ufa, 450008, Russian Federation; ORCID iD 0000-0002-5401-9407
Marsel M. Tuigunov — Dr. Sc. (Med.), Professor, Head of the Department of Microbiology and Virology, Bashkir State Medical University; 3, Lenina str., Ufa, 450008, Russian Federation; ORCID iD 0000-0002-5473-2034
Gulnur S. Sabitova — 6th year student at the Faculty of Pediatrics, Bashkir State Medical University; 3, Lenina str., Ufa, 450008, Russian Federation; ORCID iD 0009-0002-3144-7406
Contact information: Gulnara A. Azamatova; e-mail: azamatova_g@mail.ru
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 06.02.2026.
Revised 27.02.2026.
Accepted 23.03.2026.
2. Атькова Е.Л., Ярцев В.Д. Резистентный к лечению конъюнктивит как признак поражения слезоотводящих путей. Российский общенациональный офтальмологический форум. 2018;1:31–32.Atkova E.L., Yartsev V.D. Treatment-resistant conjunctivitis as a sign of damage to the lacrimal ducts. Russian National Ophthalmological Forum. 2018;1:31–32 (in Russ.).
3. Трубилин В.Н., Полунина Е.Г., Кожухов А.А. и др. Медикаментозная терапия конъюнктивитов. Литературный обзор. The EYE ГЛАЗ. 2023;25(3):225–233. DOI: 10.33791/2222-4408-2023-3-225-233Trubilin V.N., Poluninа E.G., Kozhukhov A.A. et al. Medical therapy for conjunctivitis. Literature review. The EYE GLAZ. 2023;25(3):225–233 (in Russ.). DOI: 10.33791/2222-4408-2023-3-225-233
4. Данилов А.И., Жаркова Л.П. Антибиотикорезистентность: аргументы и факты. Клиническая фармакология и терапия. 2017;26(5):6–9.Danilov A.I., Zharkova L.P. Antimicrobial resistance: arguments and facts. Clin Pharmacol Ther. 2017;26(5):6–9 (in Russ.).
5. Seppala H., Al-Juhaish M., Jarvinen H. Effect of prophylactic antibiotics on antimicrobial resistance of viridans streptococci in the normal flora of cataract surgery patients. J Cataract Refract Surg. 2004;30(2):307–315. DOI: 10.1016/S0886-3350(03)00617-5
6. Recchia F.M., Busbee B.G., Pearlman R.B. et al. Changing trends in the microbiologic aspects of postcataract endophthalmitis. Arch Ophthalmol. 2005;123(3):341–346. DOI: 10.1001/archopht.123.3.341
7. Намазова-Баранова Л.С., Баранов А.А. Антибиотикорезистентность в современном мире. Педиатрическая фармакология. 2017;14(5):341–354. DOI: 10.15690/pf.v14i5.1782Namazova-Baranova L.S., Baranov A.A. Antibiotic resistance in modern world. Pediatric pharmacology. 2017;14(5):341–354 (in Russ.). DOI: 10.15690/pf.v14i5.1782
8. Российские рекомендации. Определение чувствительности микроорганизмов к антимикробным препаратам. Версия 2025-01. МАКМАХ, СГМУ: Смоленск; 2025. Russian recommendations. Determination of the sensitivity of microorganisms to antimicrobial drugs. Version 2025-01. MAKMAKH, SMU: Smolensk; 2025 (in Russ.).
9. Астахов С.Ю., Вохмяков А.В. Офтальмологические фторхинолоны в лечении и профилактике глазных инфекций (обзор литературы). РМЖ. Клиническая офтальмология. 2008;9(1):28–30.Astakhov S.Yu., Vokhmyakov A.V. Ophthalmologic fluoroquinolones in treatment and prevention of ophthalmic infections (review of the literature). Russian Journal of Clinical Ophthalmology. 2008;9(1):28–30 (in Russ.).
10. Антропова Г.А., Оконенко Т.И. Фармацевтическое информирование: фокус на фторхинолоны. Вестник Новгородского государственного университета. 2021;3(124):65–72. DOI: 10.34680/2076-8052.2021.3(124).65-72Antropova G.A., Okonenko T.I. Pharmaceutical services: focus on fluorqinolones. Vestnik of Novgorod State University. 2021;3(124):65–72 (in Russ.). DOI: 10.34680/2076-8052.2021.3(124).65-72
11. Самуйло Е.К. Резистентность к антибиотикам бактериальных возбудителей инфекционных заболеваний глаз в России. Клиническая микробиология и антимикробная химиотерапия. 2013;15(2):106–114.Samuylo E.K. Antimicrobial resistance among bacterial pathogens causing ocular infections in Russia. Kliniceskaa mikrobiologia I antimikrobnaa himioterapia. 2013;15(2):106–114 (in Russ.).
12. Гайсина Г.Я., Азаматова Г.А. Изучение антибиотикочувствительности наиболее частых возбудителей послеоперационных воспалительных инфекционных осложнений в офтальмохирургии. Вестник Башкирского государственного медицинского университета. 2014;2(приложение):47–52.Gaysina G.Ya. Azamatova G.A. Study of antibiotic sensitivity of the most prevalent pathogens of postoperative inflammatory infectious complications in ophthalmic surgery. Bulletin of the Bashkir State Medical University. 2014;2(suppl.):47–52 (in Russ.).
13. Гайсина Г.Я. Изучение чувствительности наиболее частых возбудителей послеоперационных воспалительных инфекционных осложнений в офтальмохирургии к современным антибиотикам. Медицинский вестник Башкортостана. 2015;10(1):83–86. Gaysina G.Ya. Susceptibility of most frequent pathogens of infectious postoperative inflammatory complications in ophthalmic surgery to modern topical antibiotics. Bashkortostan medical journal. 2015;10(1):83–86 (in Russ.).
14. Ковалевская М.А., Дедова Ю.Н. Особенности клинического течения микст-вариантов глазных инфекций у носителей контактных линз: мат-лы VIII Всеросс. науч.-практ. конф. с межд. уч. «Федоровские чтения — 2009»: сб. тез. / Под общей ред. Х.П. Тахчиди. М.: Офтальмология; 2009.Kovalevskaya M.A., Dedova Yu.N. Features of the clinical course of mixed variants of eye infections in contact lens wearers. VIII All-Russian Scientific and Practical Conference with International Participation "Fedorov Readings — 2009": Collection of Abstracts. / Ed. by Kh.P. Takhtsidi. Moscow: Ophthalmology; 2009 (in Russ.).
15. Чернякова Т.В., Куроедов А.В., Волобуева Т.М. Блефариты и конъюнктивиты: что нужно знать о наиболее распространенных заболеваниях переднего отрезка глаза. Клиническая офтальмология. 2025;25(2):103–108. DOI: 10.32364/2311-7729-2025-25-2-4Chernyakova T.V., Kuroyedov A.V., Volobueva T.M. Blepharitis and conjunctivitis: what you need to know about the most common diseases of the anterior segment of the eye. Russian Journal of Clinical Ophthalmology. 2025;25(2):103–108 (in Russ.). DOI: 10.32364/2311-7729-2025-25-2-4
16. Позднякова В.В., Майчук Ю.Ф. Глазные капли Окомистин® в лечении инфекционных конъюнктивитов различной этиологии. Офтальмологические ведомости. 2012;5(2):67–71.Pozdnyakova V.V., Maychuk Yu.F. Ocomistin® eye drops in the treatment of infectious conjunctivitis of various etiologies. Ophthalmology Reports. 2012;5(2):67–71 (in Russ.).
17. Кириченко И.М. Исследование эффективности препарата Окомистин® в офтальмологии. Офтальмология. 2010;7(4):50–51.Kirichenko I.M. Study of the effectiveness of the drug Okomistin® in ophthalmology. Ophthalmology. 2010;7(4):50–51 (in Russ.).
18. Великохатская Т.А., Устименко С.Б. Опыт применения глазных капель Окомистин® в лечении эпителиальных повреждений роговицы при ношении контактных линз. Глаукома. 2011;2:73.Velikokhatskaya T.A., Ustimenko S.B. Experience in the use of eye drops Okomistin® in the treatment of epithelial corneal damage when wearing contact lenses. Glaucoma. 2011;2:73 (in Russ.).
19. Osmanov A., Farooq Z., Richardson M.D., Denning D.W. The antiseptic Miramistin: a review of its comparative in vitro and clinical activity. FEMS Microbiol Rev. 2020;44(4):399–417. DOI: 10.1093/femsre/fuaa012
20. Филатова И.А., Шеметов С.А., Кондратьева Ю.П. Лечение и профилактика инфекционных осложнений на различных этапах восстановительной хирургии. Российский офтальмологический журнал. 2024;17(3):58–65. DOI: 10.21516/2072-0076-2024-17-3-58-65Filatova I.A., Shemetov S.A., Kondratyeva Yu.P. Treatment and prevention of infectious complications at various stages of reconstructive surgery. Russian Ophthalmological Journal. 2024;17(3):58–65 (in Russ.). DOI: 10.21516/2072-0076-2024-17-3-58-65
This work is licensed under a Creative Commons «Attribution» 4.0 License.
