What antibiotics are recommended for treating an infected stye (hordeolum)?

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From the FDA Drug Label

In the treatment of suspected staphylococcal infections, therapy should be changed to another active agent if culture tests fail to demonstrate the presence of staphylococci.

The FDA drug label does not answer the question.

From the Research

For treating an infected stye (hordeolum), topical antibiotics like bacitracin ointment are typically recommended as first-line treatment, applied to the affected eyelid 2-4 times daily for 7-10 days. The choice of antibiotic is based on the most common bacterial cause of styes, which is Staphylococcus aureus. According to a study published in 2002 1, topical antibiotics such as bacitracin, neomycin, polymyxin B, mupirocin, nitrofurazone, and fusidic acid are effective against Staphylococcus aureus. Another study published in 2000 2 found that mupirocin cream was effective in reducing bacterial numbers and was similar in efficacy to oral flucloxacillin and cephalexin. However, the most recent and relevant study for the treatment of infected stye is not available, so we rely on the general principles of treating skin and soft tissue infections. Some key points to consider when treating an infected stye include:

  • Applying warm compresses to the affected eye for 10-15 minutes, 3-4 times daily to promote drainage and healing
  • Avoiding squeezing or popping the stye, as this can spread the infection
  • Seeking immediate medical attention if symptoms worsen despite treatment, or if vision becomes affected, as this may indicate a more serious infection requiring different management. It's also important to note that while oral antibiotics may be prescribed for more severe infections, topical antibiotics are generally the first line of treatment for infected styes. A study published in 2003 3 found that a topical triple-antibiotic ointment (containing neomycin, polymyxin, and bacitracin) was effective in eradicating resident bacteria on the skin, which supports the use of topical antibiotics for treating infected styes.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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