Corticosteroids for periorbital and orbital cellulitis

Area of Science:

• Ophthalmology
• Infectious Diseases
• Pharmacology

Background:

• Periorbital and orbital cellulitis are infections around and within the eye socket, respectively.
• Orbital cellulitis can lead to severe complications like vision loss, meningitis, and death.
• Corticosteroids reduce inflammation but may worsen infections.

Purpose of the Study:

• To evaluate the effectiveness and safety of using corticosteroids alongside antibiotics for periorbital and orbital cellulitis.
• To analyze these effects separately in pediatric and adult populations.

Main Methods:

• A systematic search of multiple databases (CENTRAL, MEDLINE, Embase, PubMed, LILACS, ClinicalTrials.gov, ICTRP) was conducted.
• Included were randomized and quasi-randomized controlled trials of periorbital/orbital cellulitis treated with corticosteroids.
• One trial involving 21 participants (10+ years old) comparing antibiotics with and without corticosteroids was identified.

Main Results:

• The single included trial showed no significant difference in hospital stay, antibiotic duration, or visual acuity preservation.
• Pain scores and need for surgery were also similar between groups.
• No major complications or corticosteroid side effects were reported, but assessment was limited.

Conclusions:

• There is insufficient evidence to support or refute the use of corticosteroids for periorbital and orbital cellulitis.
• High-quality randomized controlled trials are necessary to guide clinical practice.
• Future research should investigate differential effects and optimal regimens in children and adults.