General IM Q6

A 52-year-old man is evaluated for a 2-day history of painless red eye, which began on the right side and quickly spread to the left. He reports that his eyes have a thin mucopurulent discharge and that his eyelids are matted shut in the morning upon waking. He has had no photophobia, change in visual acuity, or itching in the eyes, but he has experienced some mild rhinorrhea. He does not use contact lenses. He is sexually monogamous. Medical history is significant for type 2 diabetes mellitus treated with metformin.

On physical examination, vital signs are normal. There is redness of the sclerae bilaterally, with a white crust-like residue along the edges of the eyelids. The tarsal vessels are obscured by the conjunctival erythema. Visual acuity is intact, and there is no tenderness around the globes.

Which of the following is the most appropriate treatment?

A Ceftriaxone

B Levofloxacin ophthalmic drops

C Olopatadine ophthalmic drops

D Trimethoprim–polymyxin B ophthalmic drops

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