From the Guidelines
Yes, there are topical antibiotics available for treating a hordeolum (stye), with erythromycin ophthalmic ointment being a commonly prescribed option, applied to the affected eyelid margin 3-4 times daily for 7-10 days, as supported by the most recent evidence 1.
Treatment Options
- Erythromycin ophthalmic ointment
- Bacitracin ointment
- Polymyxin B-bacitracin ointments
Application Instructions
- Use clean hands to gently place a small amount (about 1/4 inch) of ointment along the edge of the eyelid
- Be careful not to touch the eye directly with the tube
Additional Recommendations
- Apply warm compresses to the affected area for 10-15 minutes, 3-4 times daily to help bring the stye to a head and promote drainage
- Most styes will resolve within a week with this treatment, but if symptoms worsen or don't improve after 48 hours of antibiotic treatment, medical attention should be sought as oral antibiotics might be needed
Rationale
The use of topical antibiotics for hordeolum is supported by the evidence, which shows that these antibiotics can effectively reduce bacterial load and promote resolution of the infection 1. However, it is essential to note that the evidence is not uniformly strong, and some studies have raised concerns about the potential risks of antibiotic use, such as resistance and side effects 1. Nevertheless, in the context of real-life clinical practice, the benefits of topical antibiotic use for hordeolum are likely to outweigh the risks, and erythromycin ophthalmic ointment is a reasonable choice for treatment.
From the FDA Drug Label
DESCRIPTION: Erythromycin Topical Solution contains erythromycin for topical dermatologic use. The answer is no, there is no information that erythromycin topical solution is used for hordeolum. 2
From the Research
Topical Antibiotics for Hordeolum
- There is limited evidence to support the use of topical antibiotics for hordeolum, as most studies have focused on external hordeola or chronic internal hordeola 3, 4.
- A 2022 study found that the addition of an antibiotic to conservative measures for a hordeolum was not associated with an increased likelihood of treatment success 5.
- The same study found that older age was associated with a higher risk of receiving an antibiotic for a hordeolum, but this did not improve treatment outcomes 5.
- Another study from 2022 discussed the diagnosis and treatment of hordeolum and chalazion, but did not specifically address the use of topical antibiotics 6.
- Overall, the current evidence suggests that topical antibiotics may not be effective in improving the resolution of hordeolum, and more research is needed to determine the best course of treatment 3, 4, 5.
Treatment Options
- Conservative measures, such as hot or warm compresses, lid scrubs, and observation, are often recommended for the treatment of hordeolum 3, 4.
- Surgical intervention may be necessary in some cases, such as persistent or recurrent hordeolum 6.
- The use of antibiotics, including topical antibiotics, is not supported by current evidence as an effective treatment for hordeolum 5.