Medication Summary
The goals of pharmacotherapy are to treat the infection, to reduce morbidity, and to prevent complications.
Antibiotics
Class Summary
A course of oral antibiotics is indicated if the hordeolum is complicated by preseptal cellulitis.
Cephalexin (Keflex)
First-generation cephalosporin often used in skin or skin structure infections (eg, acute hordeolum) caused by staphylococci or streptococci. Administered orally and has a half-life of 50-80 min. Only 10% is protein bound and greater than 90% recovered unchanged in urine.
Erythromycin base (Ery-Tab, PCE, E.E.S. 400)
Inhibits bacterial growth, possibly by blocking dissociation of peptidyl t-RNA from ribosomes, causing RNA-dependent protein synthesis to arrest.
Indicated for infections caused by susceptible strains of microorganisms and for prevention of corneal and conjunctival infections.
Amoxicillin/clavulanate (Augmentin, Augmentin ES-600, Augmentin XR, Amoclan)
Amoxicillin inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins. Addition of clavulanate inhibits beta-lactamase–producing bacteria. Good alternative antibiotic for patients allergic to or intolerant to macrolides. Usually is well tolerated and provides good coverage for most infectious agents.
Doxycycline (Morgidox, Adoxa, Oracea)
Doxycycline inhibits protein synthesis and, therefore, bacterial growth by binding with 30S and possibly 50S ribosomal subunits of susceptible bacteria. May be added if there is history of multiple or recurrent lesions or if there is significant and chronic meibomitis.