Besivance (besifloxacin ophthalmic suspension) 0.6% is a next-generation fluoroquinolone antibacterial indicated for the treatment of bacterial conjunctivitis. Formulated specifically for ophthalmic use, it offers potent, broad-spectrum coverage against common ocular pathogens, including resistant strains. Its besifloxacin molecule is designed to minimize systemic absorption and resistance development, making it a reliable first-line option for clinicians. The suspension is preserved with benzalkonium chloride and comes in a convenient, sterile dropper bottle for patient self-administration.

Features

• Active ingredient: besifloxacin hydrochloride equivalent to 0.6% besifloxacin
• Dosage form: sterile, white to off-white opaque suspension
• Preservative: benzalkonium chloride 0.01%
• pH: approximately 6.8 (close to natural tear pH)
• Osmolality: approximately 290 mOsm/kg
• Presentation: 5 mL dropper bottle

Benefits

• Rapid bactericidal action due to dual inhibition of DNA gyrase and topoisomerase IV
• Broad-spectrum coverage against Gram-positive, Gram-negative, and atypical bacteria
• Low propensity for resistance development; no cross-resistance with other antibiotic classes
• Minimal systemic absorption, enhancing local efficacy and safety profile
• Convenient twice-daily dosing supports patient adherence
• Soothes ocular inflammation and reduces symptom duration

Common use

Besivance is indicated for the treatment of bacterial conjunctivitis caused by susceptible isolates of Aerococcus viridans, Corynebacterium pseudodiphtheriticum, Corynebacterium striatum, Haemophilus influenzae, Moraxella catarrhalis, Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus lugdunensis, Staphylococcus warneri, Streptococcus mitis group, Streptococcus oralis, Streptococcus pneumoniae, and Streptococcus salivarius. It is suitable for patients 1 year of age and older.

Dosage and direction

• Instill 1 drop into the affected eye(s) twice daily, approximately 12 hours apart, for 7 days.
• Wash hands thoroughly before use.
• Avoid touching the dropper tip to any surface to prevent contamination.
• If using other ophthalmic products, administer at least 5 minutes apart.
• Shake well before each use.
• Continue for the full treatment course even if symptoms improve earlier.

Precautions

• Not for injection or direct introduction into the anterior chamber of the eye.
• Contact lenses should not be worn during treatment.
• May cause temporary blurred vision; avoid driving or operating machinery until vision clears.
• Use with caution in patients with a history of hypersensitivity to fluoroquinolones.
• Fungal or bacterial superinfection may occur with prolonged use.
• Safety and efficacy in infants below 1 year of age have not been established.

Contraindications

• Hypersensitivity to besifloxacin, other quinolones, or any component of the formulation.
• History of tendinitis or tendon rupture associated with quinolone use.

Possible side effects

The most commonly reported adverse reactions (occurring in 1–5% of patients) include:

• Blurred vision
• Eye irritation
• Eye pain
• Eye redness
• Headache

Less common reactions (<1%) include:

• Conjunctival hemorrhage
• Dry eye
• Eye pruritus
• Increased lacrimation
• Nausea
• Rash

Drug interaction

• No formal drug interaction studies have been conducted.
• Theoretical potential for interaction with metal cation-containing products (e.g., zinc, iron, calcium supplements); separate administration by at least 2 hours.
• Use caution when co-administering with other topical ophthalmic agents due to potential for altered absorption.

Missed dose

• Apply the missed dose as soon as remembered, unless it is nearly time for the next dose.
• Do not double the dose to make up for a missed one.
• Resume the regular dosing schedule.

Overdose

• Topical overdose is unlikely due to minimal systemic absorption.
• In case of accidental ingestion, symptomatic and supportive care is recommended.
• Ocular overdose may be rinsed gently with warm water.

Storage

• Store at 2°C to 25°C (36°F to 77°F).
• Keep the bottle tightly closed when not in use.
• Discard 30 days after opening.
• Protect from light and excessive heat.
• Keep out of reach of children and pets.

Disclaimer

This information is intended for healthcare professionals. Patients should use Besivance only as directed by a qualified physician. The prescribing information provided here is a summary; refer to the full prescribing information for complete details. Individual patient responses may vary.

Reviews

Clinical studies demonstrate Besivance’s efficacy and tolerability. In randomized trials, it achieved clinical resolution in 85–90% of bacterial conjunctivitis cases by day 5, with microbial eradication rates exceeding 90%. Patients and clinicians report rapid symptom relief, easy administration, and low incidence of adverse effects. Its targeted spectrum and resistance profile make it a preferred choice among ophthalmologists and optometrists for managing bacterial conjunctivitis.