Hordeolum and Stye in Emergency Medicine Medication

  • Author: Michael J Bessette, MD, FACEP; Chief Editor: Rick Kulkarni, MD   more...
 
Updated: Apr 4, 2012
 

Medication Summary

Start therapy for hordeolum with a topical treatment. Progress to systemic therapy only if signs and symptoms of severe infection are found.

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Antibiotics

Class Summary

Topical antibiotics are useful for control of staphylococcal infections in eyelids and nares.

Bacitracin ophthalmic ointment (AK-Tracin)

 

Prevents transfer of mucopeptides into growing cell wall; inhibits bacterial cell wall synthesis.

Tobramycin ophthalmic solution or ointment (Tobrex, AKTob)

 

Interferes with bacterial protein synthesis by binding to 30S and 50S ribosomal subunits, which results in a defective bacterial cell membrane; available as solution, ointment, and lotion

Erythromycin (EES, E-Mycin, Ery-Tab)

 

First-choice treatment when systemic therapy is indicated; also indicated for treatment of infections caused by susceptible strains of microorganisms, including S aureus.

Dicloxacillin (Dycill, Dynapen)

 

For treatment of infections caused by penicillinase-producing staphylococci. May be used to initiate therapy when a staphylococcal infection is suspected.

Tetracycline (Sumycin)

 

Treats susceptible bacterial infections of both gram-positive and gram-negative organisms as well as infections caused by mycoplasmal, chlamydial, and rickettsial organisms; inhibits bacterial protein synthesis by binding with 30S and possibly 50S ribosomal subunit(s) of susceptible bacteria

Cloxacillin (Cloxapen, Tegopen)

 

For treatment of infections caused by penicillinase-producing staphylococci. May be used to initiate therapy when a staphylococcal infection is suspected.

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Contributor Information and Disclosures
Author

Michael J Bessette, MD, FACEP  Director of Emergency Medicine, Jersey City Medical Center

Michael J Bessette, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Robin R Hemphill, MD, MPH  Associate Professor, Director, Quality and Safety, Department of Emergency Medicine, Emory University School of Medicine

Robin R Hemphill, MD, MPH is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Douglas Lavenburg, MD  Clinical Professor, Department of Emergency Medicine, Christiana Care Health Systems

Douglas Lavenburg, MD is a member of the following medical societies: American Society of Cataract and Refractive Surgery

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD  Attending Physician, Department of Emergency Medicine, Cambridge Health Alliance, Division of Emergency Medicine, Harvard Medical School

Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: WebMD Salary Employment

References
  1. Hirunwiwatkul P, Wachirasereechai K. Effectiveness of combined antibiotic ophthalmic solution in the treatment of hordeolum after incision and curettage: a randomized, placebo-controlled trial: a pilot study. J Med Assoc Thai. May 2005;88(5):647-50. [Medline].

  2. Barza M, Baum J. Ocular infections. Med Clin North Am. Jan 1983;67(1):131-52. [Medline].

  3. Benton J, Karkanevatos A. Preseptal cellulitis due to Mycobacterium marinum. J Laryngol Otol. Jun 2007;121(6):606-8. [Medline].

  4. Brafman AH. Styes: a curious chain. Br J Gen Pract. Dec 1992;42(365):537-8. [Medline].

  5. Briner AM. Surgical treatment of a chalazion or hordeolum internum. Aust Fam Physician. Jun 1987;16(6):834-5. [Medline].

  6. Briner AM. Treatment of common eyelid cysts. Aust Fam Physician. Jun 1987;16(6):828, 830. [Medline].

  7. Diegel JT. Eyelid problems. Blepharitis, hordeola, and chalazia. Postgrad Med. Aug 1986;80(2):271-2. [Medline].

  8. Jackson TL, Beun L. A prospective study of cost, patient satisfaction, and outcome of treatment of chalazion by medical and nursing staff. Br J Ophthalmol. Jul 2000;84(7):782-5. [Medline].

  9. Lederman C, Miller M. Hordeola and chalazia. Pediatr Rev. Aug 1999;20(8):283-4. [Medline].

  10. Olson MD. The common stye [published erratum appears in J Sch Health 1991 Mar;61(3):138]. J Sch Health. Feb 1991;61(2):95-7. [Medline].

  11. Pavan-Langston D. Diagnosis and therapy of common eye infections: bacterial, viral, fungal. Compr Ther. May 1983;9(5):33-42. [Medline].

  12. Raskin EM, Speaker MG, Laibson PR. Blepharitis. Infect Dis Clin North Am. Dec 1992;6(4):777-87. [Medline].

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Hordeolum pointing internally
Internal side of the same hordeolum
 
 
 
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