Besifloxacin (Ophthalmic)

Approved by the FDA on May 28, 2009, besifloxacin is a fourth-generation fluoroquinolone-type ophthalmic antibiotic that is used for the treatment of bacterial conjunctivitis.


Besifloxacin is an 8-chloro fluoroquinolone anti-infective eye drop used to treat bacterial conjunctivitis, commonly known as pink eye - an infection of the membrane that covers the outer part of the eyeball and the inner parts of the eyelids. It is sold under brand name Besivance and belongs to a class of drugs called fluoroquinolones. This topical ophthalmic medication works by killing the bacteria that causes this infection. These include Pseudomonas aeruginosa, Haemophilus influenzae, Staphylococcus aureus, and Streptococcus pneumoniae. Each dose of Besivance contains 6.63 mg of besifloxacin hydrochloride equivalent to 6 mg besifloxacin base.

How to use besifloxacin

Besifloxacin is manufactured as a suspension (eye drops) to apply directly to the infected eye. Besivance should be applied to the affected eyes three times per day, 5-10 hours apart. The suspension should be used for seven days. It is important that you apply the medication at around the same times during the medication period. Ensure that you use Besifloxacin as directed by your healthcare provider or as indicated on the prescription label. Never use more or less of the medication, or apply it more often than prescribed by your healthcare provider.

The symptoms of eye infection should improve during the treatment period. Call your healthcare provider if the symptoms worsen or do not go away, or if you develop other complications with your eyes during treatment.

Continue using besifloxacin eye drops until you finish the prescription, even if your condition improves. If you skip doses, or stop using the medication too soon, your infection may not completely heal and the bacteria may develop resistance to antibiotics.

While administering besifloxacin, exercise caution not to let the tip of the dropper come into contact with your eye, fingers or any surface. This is meant to prevent bacteria from coming into contact with the medicine. Using medicine that is contaminated with bacteria and other pathogens may cause serious damage to your eye or even loss of vision. If you suspect your eye drops have been contaminated, get rid of it immediately and inform your healthcare provider.

To use besifloxacin eye drops, follow these steps:

  • Clean your hands thoroughly with soap and flowing water
  • Check the bottle tip to make sure that it is not cracked or chipped
  • Avoid touching your eyes with the dropper tip. Eyedrops must be kept as clean as possible.
  • With your head tilted back, pull down the lower lid of your finger to create a pocket
  • Hold the dropper (tip facing down) with the other hand and bring it as close as possible to the eye without touching it
  • While looking up, gently squeeze the dropper to release a single of the fluid into the pocket created in the lower eyelid.
  • With your head tipped down as though looking at the floor, close your eye for 2-3 minutes. Do not blink or squeeze your eyes.
  • Place one finger on the tear duct and apply a gentle pressure
  • Wipe any excess fluid on your face
  • If you wish to apply more than one drop on the same eye, wait about 4-5 minutes before applying the next drop
  • Replace and tighten the cap on the dropper bottle. Do not rinse or wipe the tip of the dropper
  • Clean your hands and store the medication

Conditions treated by besifloxacin

  • Bacterial conjunctivitis

Type of medicine

  • fluoroquinolone antibiotics

Side effects of besifloxacin

Along with the intended healing effects, besifloxacin may cause some undesired side effects. Although you may not experience all these side effects, consider seeking medical attention if they become severe.

Less common besifloxacin side effects

  • Blurred vision
  • red, sore eyes
  • eye pain
  • itching of the eye
  • swelling of the eye or eyelid

Some side effects may occur that do not require medical attention as they will go away as the body adjusts to treatment. Also, your healthcare provider may advise you on ways to manage these side effects.

Besifloxacin dosage

Use this medication exactly as prescribed by your pharmacist or healthcare provider. Do not apply it in larger amounts or for longer than recommended. Besifloxacin should be applied three times per day for 7 days. Follow your healthcare provider's instruction and space your doses at least five hours apart.

Missed besifloxacin dose

If you miss your besifloxacin dose, apply it as soon as you remember. However, if the next dose is barely an hour away, skip the missed dose and resume your regular dosing schedule. Do not apply an extra dose to make up for the missed dose.

Besifloxacin overdose

Besifloxacin overdose is unlikely to cause life-threatening symptoms. However, seek advice from your healthcare provider if you think you have applied too much of the drop.

Besifloxacin Interactions

Do not use besifloxacin while wearing contact lenses as the medication may contain preservatives that may be absorbed by the soft contact lenses. Wait at least 20 minutes after applying the drop before putting your contact lenses back in.

Do not wear contact lenses while you still have active symptoms of the eye infection you are treating.

It is unlikely that other medications you inject or take orally will have an effect on besifloxacin eye drops. However, most drugs tend to interact with each other. Inform your doctor about any medications you are currently on, including over-the-counter medications, mineral, supplements, drugs prescribed by other doctors, as well as herbal products. Do not start new medications without informing your healthcare provider.

Besifloxacin warnings

Before using this medication:

  • Inform your healthcare provider or pharmacist if you are allergic to besifloxacin, any fluoroquinolone or quinolone antibiotics such as gatifloxacin (Zymar), ciprofloxacin (Cipro, Ciloxan), levofloxacin, gemifloxacin, lomefloxacin, nalidixic acid, moxifloxacin, norfloxacin, sparfloxacin, and ofloxacin. Also, inform your healthcare provider if you are allergic to any of the ingredients in besifloxacin.
  • Tell your healthcare provider about any other medication you are presently taking
  • Tell your healthcare provider if you have ever had an eye infection before
  • Inform your doctor if you are pregnant or breastfeeding
  • Inform your healthcare provider if you use contact lenses. You should not wear contact lenses while under medication.
  • You should note that bacterial conjunctivitis can spread quite fast. Wash your hands clean, with soap and flowing water, after touching your eyes. Once the infection is healed, wash or replace contact lenses and other eye makeups that were in contact with the infected eye.
  • Do not stop the medication before completing the prescribed dosage
  • Contact your healthcare provider if your eye infection does not improve, or worsens, after medication
  • Stop using besifloxacin and contact your healthcare provider right away if you develop rashes, itching, or red, swollen skin around the eyelid. These could be symptoms of allergic reactions.
  • Do not expose your eyes to high-density lighting while on medication. Use shades to reduce the amount of light entering your eyes while outdoors on a sunny day.

Besifloxacin storage

Keep besifloxacin in the container it came with, tightly closed and out of reach of pets and children. Store the medication at room temperature away from excess heat, direct light and moisture. Do not keep besifloxacin in your car where it might be exposed to extreme heat.

Unused or expired medications should be disposed of appropriately to ensure that children and pets do not consume them. Do not flush this, or other medications, down the toilet or kitchen sink. Talk to your local pharmacist or the local garbage company to learn how you can best dispose of unused or expired medication.


Besifloxacin belongs to a group of antibiotics known as fluoroquinolones. It is used to treat bacterial infections. Besifloxacin ophthalmic is applied into the eyes to treat conjunctivitis - a bacterial infection of the eye.

Besifloxacin should not be used by individuals who are allergic to besifloxacin, or any of the ingredients used in the medicine. The medicine should be used exactly as prescribed by your healthcare provider or pharmacist. Do not apply it in larger amounts or for longer than advised by your doctor. Carefully read and follow the directions on the prescription label before using the medicine.

Serious side effects of besifloxacin ophthalmic may include severe irritation on the treated eye, eye drainage or crusting, eye swelling or redness, feeling like there is a foreign object in the eye, fever and signs of new infection. Some of these symptoms will go away as the body adjusts to the medication. However, consider seeking medical attention if these side effects persist or worsen.

Ensure that you use besifloxacin for the full prescribed length of time (three times per day for 7 days). Do not stop the treatment because the symptoms have improved.

Do not use besifloxacin if you are wearing contact lenses as the medication may contain preservatives that can be absorbed into the lenses. Wait for at least 20 minutes after applying besifloxacin before putting your contact lenses back.

Last Reviewed:
December 24, 2017
Last Updated:
April 04, 2018
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