Orbital Infections: A Complete Cycle 7-Year Audit and a Management Guideline

Abstract

Orbital infections are regularly encountered and are managed by various healthcare disciplines. Sepsis of the orbit and adjacent tissues can be associated with considerable acute complication and long term sequelae. Therefore, prompt recognition and management of this condition are crucial. This article presents the outcomes of a 7-year complete cycle audit project and describes the development of the new local guideline on the management of orbital infections in our tertiary centre. Methods:1. A retrospective 5-year audit cycle on patients with orbital infections 2. A review of available evidence on the management of orbital infections A new local multidisciplinary guideline on the management of orbital infections A retrospective 2-year second audit cycle to assess the clinical outcomes Results:Various disciplines intersect in the management of orbital infections. Standardising the management of this condition proved to be achievable through the developed guideline.However, room for improvement in practice exists in areas such as the promptness in referring patients to specialist care, the multidisciplinary assessment of patients on admission, and the improvement of scanning requests of patients.

Approach to Orbital Complications in Rhinosinusitis

“…Good results have been reported in the literature with 3rd-generation cephalosporins, clindamycin and metronidazole in combination, and sulbactam-ampicillin, and researchers stress the need for intravenous antibiotic therapy to last for 7-14 days. [8,9] In the literature, there are different approaches described to achieve surgical drainage in cases where a subperiosteal or orbital abscess develops. Garcia et al [10] monitored abscesses that were small, medial and not secondary to a tooth infection, in patients under nine years of age on medical therapy.…”