From the Guidelines
Topical antibiotics such as doxycycline, minocycline, or tetracycline are recommended to treat hordeolum, with oral erythromycin or azithromycin as alternatives, especially in women of childbearing age and children. When considering treatment options for hordeolum, it is essential to prioritize morbidity, mortality, and quality of life as outcomes. According to the most recent and highest quality study available, 1, topical antibiotics may be helpful in treating hordeolum. The study suggests that doxycycline, minocycline, or tetracycline can be given daily and tapered after clinical improvement is noted.
Treatment Options
- Topical antibiotics: doxycycline, minocycline, or tetracycline
- Oral antibiotics: erythromycin or azithromycin, especially in women of childbearing age and children
- Treatment duration: until clinical improvement is noted, with the option to taper or discontinue as needed
Important Considerations
- Tetracyclines have anti-inflammatory activity and can decrease lipase production in bacteria, but may cause side effects such as photosensitization, gastrointestinal upset, and vaginitis 1
- Azithromycin has been used successfully in the management of acne rosacea, but may lead to abnormalities in the electrical activity of the heart, with the potential to create serious irregularities in heart rhythm 1
- Topical and systemic ivermectin have been shown to reduce or eliminate the number of D. folliculorum found in the epilated lashes of patients with blepharitis or ocular rosacea, but are not specifically recommended for hordeolum treatment in this study 1
From the FDA Drug Label
No information is provided in the given drug labels that directly supports the use of specific antibiotics for the treatment of hordeolum.
The FDA drug label does not answer the question.
From the Research
Antibiotics for Hordeolum
- There is limited evidence on the effectiveness of antibiotics for treating hordeolum, as most studies focus on external hordeola or chronic internal hordeola 2, 3.
- One study compared acupuncture with conventional treatments, including topical antibiotics, and found that resolution of acute hordeolum was more likely in the acupuncture group 4.
- Another study reported a case of upper eyelid necrosis secondary to hordeolum, which was successfully treated with surgical cleansing, drainage, and endovenous antibiotics 5.
- A review of hordeolum and chalazion diagnosis and treatment noted that while most lesions resolve spontaneously, surgical intervention may be necessary in some cases, and malignant tumors must be excluded as a differential diagnosis 6.
Types of Antibiotics
- Topical antibiotics were used in some studies as a conventional treatment for hordeolum 4.
- Oral antibiotics were also used in combination with warm compresses in one study 4.
- Endovenous antibiotics were used to treat a case of upper eyelid necrosis secondary to hordeolum 5.
Effectiveness of Antibiotics
- The evidence on the effectiveness of antibiotics for treating hordeolum is limited and of low certainty 4.
- One study found that acupuncture was more effective than topical antibiotics in resolving acute hordeolum 4.
- Another study reported that a combination of acupuncture and conventional treatments, including topical antibiotics, may provide short-term benefits for treating acute hordeolum 4.