From the FDA Drug Label
Adults and children 2 years of age and older: apply to the affected area no more than 3 to 4 times daily For topical use only Sodium Fusidate
The most appropriate topical antibiotic for an unresolved stye between erythromycin and fusidic acid cannot be determined from the provided drug labels as they only discuss fusidic acid.
- Fusidic acid is mentioned for topical use, but there's no direct comparison or mention of erythromycin.
- The provided information does not support a clinical decision between erythromycin and fusidic acid for this specific use 1, 1, 1.
From the Research
For an unresolved stye, erythromycin ophthalmic ointment is generally the most appropriate first-line topical antibiotic treatment over fusidic acid. Apply a small amount of erythromycin 0.5% ophthalmic ointment to the affected eyelid margin 2-3 times daily for 7-10 days. Gently clean the eyelid with warm compresses before application to remove any crusting and improve medication penetration. Erythromycin is preferred because it provides excellent coverage against Staphylococcus aureus, which is the most common bacterial cause of styes (hordeolum) 2. It also has good tissue penetration into the meibomian glands and follicles. While fusidic acid is also effective against Staphylococcus, it is typically reserved as a second-line option in cases where erythromycin is not tolerated or has failed.
Some key points to consider when choosing between erythromycin and fusidic acid include:
- The efficacy of fusidic acid against Staphylococcus aureus, as shown in studies such as 3 and 4
- The potential for resistance to fusidic acid, as discussed in 4 and 5
- The convenience and compliance with treatment, as noted in 6
If the stye doesn't improve after 48 hours of antibiotic treatment, continues to worsen, or if you develop fever or spreading redness, seek medical attention as incision and drainage might be necessary. It's essential to weigh the benefits and risks of each treatment option, considering the most recent and highest-quality evidence available, such as the studies mentioned above 2, 3, 4, 6, 5.