Why should topical antibiotics not be prescribed for styes?

Topical antibiotics should not be prescribed for styes unless there is evidence of conjunctivitis because styes are typically caused by a blockage in the oil glands of the eyelid rather than a bacterial infection that would necessitate antibiotic treatment. A stye can develop from the overgrowth of bacteria normally found on the skin, but it is largely a localized issue that typically resolves without the need for antibiotic therapy.

If there is a concurrent bacterial conjunctivitis, which is an infection of the conjunctiva, then the use of antibiotics may be warranted to address the underlying infection. However, using topical antibiotics for a stye alone does not treat the stye effectively and may lead to unnecessary medication use without addressing the root cause of the problem.

In this context, prescribing topical antibiotics without clear signs of conjunctivitis would not align with recommended treatment practices for styes. Thus, only considering antibiotics if conjunctivitis is present makes sense from both a clinical and a prudent prescribing standpoint.