Related Experiment Videos
Periorbital cellulitis: a comparison of different treatment regimens
1Department of Pediatric Infectious Diseases, Hacettepe University Children's Hospital, Ankara, Turkey.
Insights
Sinusitis is the leading cause of periorbital cellulitis in children. Sulbactam-ampicillin (SAM) demonstrated a lower recurrence rate compared to penicillin plus chloramphenicol, suggesting it as a preferred first-line treatment.
Area of Science:
- Pediatric infectious diseases
- Ophthalmology
Background:
- Periorbital cellulitis is a common infection in children.
- Identifying causative factors and optimal treatment is crucial for effective management.
Purpose of the Study:
- To determine the primary causes of periorbital cellulitis in a pediatric cohort.
- To evaluate the efficacy of different antimicrobial regimens for treating periorbital cellulitis.
Main Methods:
- Retrospective investigation of 69 children (1.5-16 years) with periorbital cellulitis.
- Analysis of associated conditions, predisposing factors, and microbial isolates.
- Comparison of treatment outcomes between penicillin plus chloramphenicol and sulbactam-ampicillin (SAM) regimens.
Main Results:
- Sinusitis was the most frequent associated condition (43%), followed by trauma (25%).
- Staphylococcus aureus was the predominant pathogen (74% of isolates).
- SAM showed a lower recurrence rate (3%) compared to penicillin plus chloramphenicol (17%).
Conclusions:
- Sinusitis and trauma are key predisposing factors for pediatric periorbital cellulitis.
- Sulbactam-ampicillin (SAM) is a potentially superior first-line treatment due to its broad spectrum and lower recurrence rates.
- SAM offers a safe and effective option for periorbital cellulitis across various etiologies and age groups.
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.