• Ocular infections

Besivance Generic Name & Formulations

General Description

Besifloxacin 0.6%; oph susp; contains benzalkonium chloride.

Pharmacological Class


How Supplied



Store at 15°C to 25°C (59°F to 77°F). Protect from light.


Besivance Indications


Susceptible bacterial conjunctivitis.


Besivance is indicated for the treatment of bacterial conjunctivitis caused by susceptible isolates of the following bacteria:

Aerococcus viridans

CDC coryneform group G

Corynebacterium pseudodiphtheriticum

Corynebacterium striatum

Haemophilus influenzae

Moraxella catarrhalis

Moraxella lacunata

Pseudomonas aeruginosa

Staphylococcus aureus

Staphylococcus epidermidis

Staphylococcus hominis

Staphylococcus lugdunensis

Staphylococcus warneri

Streptococcus mitis group

Streptococcus oralis

Streptococcus pneumoniae

Streptococcus salivarius

Besivance Dosage and Administration

Adults and Children

<1yr: not established. ≥1yr: 1 drop in affected eye(s) 3 times daily (4–12hrs apart) for 7 days. Shake bottle once before use.

Besivance Contraindications

Not Applicable

Besivance Boxed Warnings

Not Applicable

Besivance Warnings/Precautions


Not for inj into the eye. Avoid contact lenses during therapy or if symptomatic.  Prolonged use may result in overgrowth of nonsusceptible organisms. Pregnancy. Nursing mothers.

Pregnancy Considerations

There are no available human data for the use of Besivance during pregnancy to inform any drug-associated risks; however, systemic exposure to besifloxacin from ocular administration is low.

Nursing Mother Considerations

There are no data on the presence of Besivance in human milk, the effects on the breastfed infant, or the effects on milk production. Consider benefits for mother vs potential risks to infant. Systemic exposure following topical ocular administration is low.

Pediatric Considerations

The safety and effectiveness of Besivance in infants less than 1 year of age have not been established. There is no evidence that the ophthalmic administration of quinolones has any effect on weight-bearing joints.

Geriatric Considerations

No overall differences in safety and effectiveness have been observed between elderly and younger patients.

Besivance Pharmacokinetics


Following the first and last dose, the maximum plasma besifloxacin concentration in each patient was less than 1.3ng/mL. The mean besifloxacin Cmax was 0.37 ng/mL on day 1 and 0.43ng/mL on day 6.


The average elimination half-life of besifloxacin in plasma following multiple dosing was estimated to be 7 hours.

Besivance Interactions

Not Applicable

Besivance Adverse Reactions

Adverse Reactions

Conjunctival redness, blurred vision, eye pain/pruritus/irritation, headache; superinfection (discontinue and treat).

Besivance Clinical Trials

Clinical Trials

In a randomized, double-masked, vehicle-controlled, multicenter clinical trial, in which patients 1-98 years of age were dosed 3 times a day for 5 days, Besivance was superior to vehicle in patients with bacterial conjunctivitis. 

Clinical resolution was achieved in 45% (n=90/198) for the Besivance-treated group vs 33% (n=63/191) for the vehicle-treated group (difference 12%; 95% CI, 3-22). 

Microbiological outcomes demonstrated a statistically significant eradication rate for causative pathogens of 91% (n=181/198) for the Besivance-treated group vs 60% (n=114/191) for the vehicle-treated group (difference 31%; 95% CI, 23-40). 

Microbiologic eradication does not always correlate with clinical outcome in anti-infective trials.

Besivance Note

Not Applicable

Besivance Patient Counseling

Patient Counseling

Avoid contaminating the applicator tip.

Do not wear contact lenses during therapy.

Invert bottle and shake once before each use.

Cost Savings Program