Periorbital cellulitis: A comparison of different treatment regimens

Abstract

Periorbital cellulitis was retrospectively investigated in a cohort of 69 children, 1.5–16 years of age, who were admitted to Hacettepe University Children's Hospital. The aim of the study was to define the most important cause of the disease and to choose the most appropriate antimicrobial regimen. Sinusitis (43%) was found to be the most frequent disease associated with periorbital cellulitis. Trauma (25%) and odontogenic infections (6%) were the next most common predisposing causes. Staphylococcus aureus was isolated from 14 (74%) of 19 cultures. Two antibiotic combinations, penicillin plus chloramphenicol and sulbactam‐ampicillin (SAM) with or without ornidazole was used in 30 (43%) and 39 (57%) of 69 cases, respectively. The duration of treatment with these two antibiotic combinations was generally between 7 and 10 days. No statistical difference was found between the two antibiotic combinations in the cure and recurrence rates but five (17%) of the 30 cases using penicillin plus chloramphenicol, and one (3%) of the 39 cases using SAM with or without ornidazole had recurrent periorbital cellulitis. It was concluded that SAM can be the first line of drug treatment for periorbital cellulitis as it is easily used in every age group and etiology (trauma, sinusitis, etc.). It provides total recovery and has less side effects and risk of recurrence. It also has a broad antimicrobial spectrum.

Evaluation of patients with orbital infections

“…In all our patients with orbital cellulitis, the most common predisposing factor was found to be paranasal sinusitis. Kanra et al (16) from our country reported that 43% of cases of orbital tissue infection developed secondary to sinusitis. Again, Çiftçi et al (17) reported that infections developed following paranasal sinusitis with a rate of 65% in a study in which 20 patients were evaluated.…”

Experience with Ampicillin/Sulbactam in Severe Infections

“…16 These infections are a particular problem in children as the skin and subcutaneous tissue of the eyelid is extremely thin and pus can easily accumulate and penetrate the intracranial cavity. Periorbital infections are usually caused by H. influenzae, with S. aureus being the second most commonly isolated pathogen.…”

Periorbital ve Orbital Sellülitin Ampisilin-Sulbaktam İle Tedavisi

“…H. influenzae tip b aşısının yaygınlaştığı bölgelerde S. pneumoniae kan kültürlerinden en sık izole edilen etken haline gelmiştir (11). Ülkemizden bildirilen bir araştırmada ise periorbital sellülitli çocukların kan kültüründen en sık izole edilen etken S. aureus olmuştur (12). Kan kültüründen etkenin izole edilme oranı çok düşük olmasına karşın periorbital veya orbital sellülitli bütün çocuklardan antibiyotik tedavisine başlamadan önce kan kültürü alınmalıdır.…”