Which penicillin is recommended for eyelid infections, such as hordeolum and preseptal cellulitis?

Dicloxacillin is the preferred choice for eyelid infections such as hordeolum and preseptal cellulitis due to its efficacy against staphylococcal infections, which are commonly implicated in these conditions. Staphylococcus aureus is a frequent pathogen associated with eyelid infections, and dicloxacillin is specifically formulated to combat resistant strains of this bacteria, including methicillin-resistant Staphylococcus aureus (MRSA).

Furthermore, dicloxacillin has good oral bioavailability and is less susceptible to degradation by gastric acid, making it a practical choice for outpatient treatment. It also has a narrow spectrum of activity, which minimizes disruption to normal flora while effectively targeting the pathogens likely responsible for these eyelid conditions.

While other penicillins like amoxicillin do have broader activity, they are generally less effective against staphylococcal infections. Piperacillin and cloxacillin, although they have specific uses, are not the first line for outpatient management of simple eyelid infections.