From the Research
For a hordeolum (stye) that is resistant to erythromycin, azithromycin hydrate ophthalmic solution is a highly effective alternative treatment, as evidenced by a recent study published in 2023 1. This study demonstrated the efficacy of azithromycin hydrate ophthalmic solution in treating internal hordeolum and meibomitis, with significant improvement in inflammatory findings, particularly in patients with phlyctenular keratoconjunctivitis. The use of azithromycin hydrate ophthalmic solution is supported by its broad-spectrum activity against gram-positive bacteria, including Staphylococcus species, which are common causes of styes. Some key points to consider when treating a hordeolum that is resistant to erythromycin include:
- The importance of warm compresses applied for 10-15 minutes, 4-6 times daily to bring the stye to a head and promote drainage
- The potential need for oral antibiotics, such as dicloxacillin or cephalexin, for more severe or persistent cases
- The consideration of underlying conditions, such as blepharitis or diabetes, if the stye persists or recurs frequently It is also worth noting that the use of antibiotics, including azithromycin, should be guided by the results of culture testing and susceptibility patterns, as well as clinical judgment and patient-specific factors, as highlighted in studies such as 2 and 3. However, based on the most recent and highest quality evidence, azithromycin hydrate ophthalmic solution is a recommended alternative treatment for a hordeolum that is resistant to erythromycin.