Objectives. To describe the experience of orbital complications of ARS in the paediatric population and to identify risk factors associated with disease severity. Methods: This retrospective analysis evaluated the clinical outcomes of 78 children hospitalised for orbital complications between 2005 and 2020. Descriptive statistics were used to examine demographic data and clinical symptoms. Results. Although all children were treated with antibiotics prior to hospitalisation, more than half of this cohort experienced post-septal orbital complications. A significant association was found between age at admission and severity of illness. Children over seven years of age had more severe orbital complications and were more likely to require surgery despite the administration of antibiotics prior to hospitalisation (p < 0.001). Conclusions. In this study, stage II and III orbital complications at admission and older age were the most important determinants of failure of medical treatment. Early referral to an otolaryngologist should be considered for children older than seven years with ORS, as more severe orbital complications may occur despite preclinical antibiotics.
<p><strong>Background:</strong> The aim of the study was to identify predictors of disease severity and describe the characteristics of orbital complications as the direct result of ARS in children.</p><p><strong>Methods:</strong> Through retrospective study, we investigated 78 children with stage I-IV orbital complications between 2005 and 2020 in regional multidisciplinary children's medical center. Samples were obtained for the microbiological analyses. Statistical tests and descriptive statistical methods were used.</p><p><strong>Results:</strong> The research included 78 children who were hospitalized for orbital complications after ARS. There were 44 male patients (56.4%), with a sex ratio of 1.29:1. <em>Staphylococcus aureus</em> was cultured in 31 (34.8%) of patients, followed by <em>Streptococcus pyogenes</em> in 26 (29.2%). We found a significant association between age, severity of complications and treatment outcomes. The age of over seven years was associated with more severe orbital complications (stage II-III) and the need of surgical intervention (p<0.001). Pre-clinical antibiotic administration had no significant influence on illness severity at the time of presentation (p=0.38).</p><p><strong>Conclusions</strong>: In this study, severe orbital complications and the age of over seven years were determinants the antibiotic failure. Clinicians should consider early referral of children older than seven years with orbital complications for better treatment outcomes.</p>
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