First line: lid hygiene for symptom control, including: warm compresses; lid massage and scrubs; gentle washing and avoiding cosmetics.

Second line: If hygiene measures for 2 weeks are ineffective, use topical antibiotics.

Signs of meibomian gland dysfunction or acne rosacea: consider oral antibiotics. Seek advice from Microbiology or Ophthalmology for treatment in children.

Drug details

Second line

Chloramphenicol 1% ointment twice daily rubbed into the lid margin

6 week trial

Signs of meibomian gland dysfunction or acne rosacea

For acne rosacea, see TAM guidance

Doxycycline 100mg once daily initially

for 4 weeks

THEN 50mg once daily as maintenance

for 8 weeks

Last reviewed: 23/02/2023

Next review date: 28/02/2026

Author(s): Antimicrobial Management Team.

Approved By: TAM Subgroup of ADTC

Reviewer name(s): Area Antimicrobial Pharmacist.

Document Id: AMT112