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Evaluation of mild periorbital cellulitis and home-based therapy in children-EPOCH study: A prospective single centre
Shefali Jani1,2, Deepali Thosar1, Zachary McPherson1,2
1Emergency Department, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.
Insights
Ambulatory care is a safe and effective strategy for managing mild paediatric periorbital cellulitis. This approach can prevent hospitalizations and improve community-based patient care.
Area of Science:
- Ophthalmology
- Pediatric Emergency Medicine
- Infectious Diseases
Background:
- Paediatric periorbital cellulitis requires prompt management to prevent complications.
- There is a lack of international consensus on the optimal ambulatory management of mild cases.
- This study aimed to evaluate the safety and effectiveness of outpatient care for mild periorbital cellulitis in children.
Purpose of the Study:
- To prospectively investigate the safety and effectiveness of ambulatory management for children with mild periorbital cellulitis.
- To assess the feasibility of outpatient treatment and follow-up for this condition.
Main Methods:
- Prospective enrollment of 70 children (aged 2-16 years) with mild periorbital cellulitis over 23 months.
- Children received oral antibiotics and were discharged with close ambulatory care and ophthalmology follow-up.
- Descriptive statistics were used for data analysis.
Main Results:
- The aetiology of periorbital cellulitis was unknown in 43% of cases.
- 92% of children received structured ambulatory follow-up, with only 7% requiring inpatient parenteral antibiotics.
- One case of orbital cellulitis occurred during follow-up; no mortality or significant morbidity was observed, and no surgical interventions were needed.
Conclusions:
- Ambulatory care is a safe and effective strategy for managing mild paediatric periorbital cellulitis.
- Outpatient management can potentially reduce hospitalizations and decrease the burden on hospital resources.
- This approach supports community-based patient care for pediatric eye infections.
Background:
Paediatric periorbital cellulitis is a common eye condition and warrants prompt management for the prevention of complications. International consensus on the approach to optimal management of children with mild periorbital cellulitis including ambulatory management is lacking. We aimed to prospectively investigate the safety and effectiveness of ambulatory management of children with mild periorbital cellulitis.
Methods:
Over a 23-month period, we prospectively enrolled 70 children aged between 2 and 16 years who presented to the emergency department with mild periorbital cellulitis. Demographic and clinical data were collected. Eligible children were commenced on oral antibiotics and were discharged home with close outpatient ambulatory care and ophthalmology follow up. We used descriptive statistics for data presentation.
Results:
Of the 70 children with mild periorbital cellulitis, 30 (43%) had unknown aetiology. Sixty-five (92%) children received a structured ambulatory follow up. Five children (7%) received inpatient parenteral antibiotics for worsening of local symptoms within 24 h of initial presentation. One child developed orbital cellulitis at follow up. There was no mortality or significant morbidity noted in this group and none of the children needed surgical intervention.
Conclusions:
Ambulatory care for children with mild periorbital cellulitis is an effective and safe management strategy. This might prevent hospitalisation, reduce the burden on hospital bed occupancy and promote patient care in the community.
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