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Published on: February 9, 2011
[Preseptal and orbital cellulitis in childhood: response to intravenous antibiotics]
M C Durán-Giménez-Rico1, A Boto-de-los-Bueis, M J Alberto
1Hospital San Rafael, Madrid, Spain.
Insights
Empiric antibiotic treatment for pediatric preseptal and orbital cellulitis showed varied responses. Cefotaxime was more effective than cefuroxime, especially when acute dacryocystitis was present.
Area of Science:
- Ophthalmology
- Pediatric Infectious Diseases
Background:
- Preseptal and orbital cellulitis are common pediatric infections.
- Empiric antibiotic therapy is the standard initial treatment.
Purpose of the Study:
- To retrospectively evaluate the effectiveness of empiric antibiotic treatment for preseptal and orbital cellulitis in children.
- To compare the response rates of different antibiotics and identify potential contributing factors.
Main Methods:
- Retrospective review of nine pediatric patients diagnosed with preseptal or orbital cellulitis between October 2002 and October 2003.
- Analysis of patient demographics, clinical presentation, associated conditions, and antibiotic treatment regimens.
Main Results:
- 44.4% of patients responded to initial empiric antibiotic treatment; 55.5% required a second antibiotic.
- Cefotaxime was effective in 3 out of 4 patients, while cefuroxime was effective in only 1 out of 5 patients.
- Acute dacryocystitis was identified in two non-responding patients and was associated with a lack of response to cefuroxime.
Conclusions:
- Acute dacryocystitis is a significant underlying cause of pediatric preseptal and orbital cellulitis.
- Cefotaxime demonstrated a better response rate compared to cefuroxime for empiric treatment.
- Prompt identification and management of acute dacryocystitis are crucial for successful treatment outcomes.
Purpose:
To evaluate retrospectively the response of preseptal and orbital cellulitis in children to empiric antibiotic treatment.
Method:
We included nine patients (five male and four female) admitted to our hospital between October 2002 and October 2003 because of preseptal or orbital cellulitis.
Results:
Four patients (44.4%) responded to empiric antibiotic treatment (R); five (55.5%) did not respond (NR) and required a second antibiotic to resolve the infection. The presence of an upper respiratory infection was the most common associated disease in both groups, R and NR. However we also found two cases of acute dacryocystitis in the NR. Four patients (44.4%) were treated with cefotaxime intravenously with the infection resolving in three of these. Five patients (55.6%) were treated with cefuroxime intravenously as first empiric option, however only one patient responded.
Conclusions:
We found a high prevalence of acute dacryocystitis as a potential cause of the cellulitis. Children with preseptal and orbital cellulitis responded better to cefotaxime than to cefuroxime. The presence of acute dacryocystitis was associated with a lack of response to cefuroxime.
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