Guidelines
Orbital cellulitis

Orbital cellulitis

Most Likely Pathogens

Consult

ENT, Opthalmology, ID and/or relevant subspecialty team(s) if required

Culture

Before starting antimicrobial therapy, take blood/urine/CSF and/or other relevant samples for culture wherever possible.

Notes

Consider the need for dose adjustments (e.g. renal impairment) and age-related contraindications for antimicrobials.

First Choice

Cefotaxime may be interchanged with ceftriaxone for children over 30 days old and not on calcium-containing parenteral products (e.g. TPN).

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As anti-MRSA agent (current local MRSA rates are available via the hospital antibiogram)

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Penicillin Allergy

Cefotaxime may be interchanged with ceftriaxone for children over 30 days old and not on calcium-containing parenteral products (e.g. TPN).

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As anti-MRSA agent (current local MRSA rates are available via the hospital antibiogram)

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Review Daily

Adjust treatment according to microbiologic results as soon as they become available.

Additional Information

The following factors have been associated with MRSA in previous studies:

  • Previous known MRSA infection in child or a significant contact (e.g. family member)

  • Family member is a healthcare worker

  • First nations child or Pacific Island origin (e.g. Samoan)

  • Day care attendance

  • Prolonged hospitalization in the last 1 year

  • Antibiotic therapy in the last 2 months

  • Critically ill

  • Chronic skin condition (e.g. atopic eczema)