Stye Treatment: Recommended Eye Drops
For a stye (hordeolum), use topical antibiotic ointment applied directly to the lid margin 1-3 times daily, with bacitracin ophthalmic ointment being the FDA-approved first-line treatment. 1
Primary Treatment Approach
Apply antibiotic ointment directly to the eyelid margin rather than drops into the conjunctival sac, as this targets the site of infection more effectively for lid margin conditions like styes. 1
Specific Antibiotic Recommendations
Bacitracin ophthalmic ointment is the FDA-labeled treatment for blepharitis and lid margin infections, applied 1-3 times daily after carefully removing all scales and crusts from the lid margins. 1
Alternative ointments include erythromycin or gentamicin if the causative bacteria show resistance to bacitracin. 2
Antibiotic drops placed in the conjunctival sac (such as ofloxacin or levofloxacin) are equally effective as ointment in reducing bacterial colonization on lid margins, though ointment allows more direct application to the affected area. 2, 3
Important Treatment Considerations
Avoid combination steroid-antibiotic preparations as initial therapy for any suspected bacterial eye infection, as corticosteroids should only be added after the infection is controlled and the organism identified. 4
Topical antibiotics demonstrate modest benefit, with clinical remission rates improving from 41% with placebo to approximately 50% with antibiotics by days 6-10. 5
Warm compresses should be applied as adjunctive therapy to help promote drainage and resolution. 6
Treatment Duration and Monitoring
Continue antibiotic therapy for 3-7 days or until clinical resolution occurs. 3, 6
Most styes resolve within one week with appropriate treatment; if no improvement occurs within this timeframe, surgical incision and drainage may be necessary. 3, 6
Do not taper antibiotics below therapeutic dosing, as subtherapeutic levels increase antibiotic resistance risk. 4
Common Pitfalls to Avoid
Never use corticosteroid-containing drops (such as Tobradex) as initial monotherapy for styes, as steroids can worsen bacterial infections and are only appropriate after infection control is established. 4
Avoid indiscriminate use of topical antibiotics, as prolonged use causes toxicity and should be limited to the treatment duration needed. 7, 4
Ensure patients avoid gross contamination of the ointment tube when applying directly to the infected area. 1