Periorbital cellulitis is an infection of the eyelid and the surrounding tissues that causes redness and swelling. This condition affects infants and children more commonly and may be caused by a trauma to the area or the spread of an infection from other parts of the body, according to Richard A. Helms and David J. Quan in the 2006 "Textbook of Therapeutics: Drug and Disease Management." The treatment for periorbital cellulitis depends on the bacteria involved in the infection and on the seriousness of the infection. Some patients are treated with antibiotics intravenously and others can be treated with oral medications.
Antibiotics for Outpatient Therapy
For patients with periorbital cellulitis who have no systemic symptoms associated with the condition or who have an obvious skin cause, the physician may start with oral antibiotics, according to Gary R Fleisher and Stephen Ludwig in the 2010 "Textbook of Pediatric Emergency Medicine." If the infection was caused by a trauma, the typical causative bacterias include Staphylococcus aureus and Streptococcus pyogenes, according to Helms and Quan. Oral antibiotics that may be used in this case include the cephalosporin cephalexin, the penicillin dicloxacillin and clindamycin. If the periorbital cellulitis does not improve over one to two days, the patient may need to be admitted for IV antibiotics. Patients may also be switched to oral antibiotics after initial therapy with IV antibiotics.
Penicillins
Periorbital cellulitis may require IV antibiotics. IV penicillins like oxacillin or the ampicillin-sulbactam combination are effective for the family of Streptococcus bacteria and most Staphylococcus types, according to Helms and Quan. The IV antibiotic treatment is given until the swelling and other symptoms are significantly improved, according to Randall G. Fisher, Thomas G. Boyce and Hugh L. Moffet in the 2005 book "Moffet's Pediatric Infectious Diseases: A Problem-Oriented Approach."
Cephalosporins
The physician may also prescribe an IV cephalosporin antibiotic like cephazolin to treat periorbital cellulitis; these antibiotics are effective for treating Streptococci and most Staphylococcus types, according to Helms and Quan. Some periorbital infections in children may be caused by Haemophilus influenzae; if the physician suspects that this bacteria may be the culprit, other newer cephalosporins like cefuroxime or cefotaxime can be used, according to Lynn C. Garfunkel, Jeffrey Kaczorowski and Cynthia Christy in the 2002 book "Mosby's Pediatric Clinical Advisor: Instant Diagnosis and Treatment."
Vancomycin
For patients with periorbital cellulitis and systemic illness, the clinicians should be concerned about the presence of Streptococcus pneumoniae, according to Helms and Quan. The IV medication vancomycin can be used in this situation. According to The Merck Manuals, vancomycin can also be used for patients who have a methicillin-resistant Staphylococcus aureus infection; this Staphylococcus species is resistant to both penicillin and cephalosporin antibiotics.
References
- "Textbook of Therapeutics: Drug and Disease Management;" Richard A. Helms, David J. Quan; 2006.
- "Textbook of Pediatric Emergency Medicine;" Gary R Fleisher, Stephen Ludwig; 2010.
- Moffet's Pediatric Infectious Diseases: A Problem-Oriented Approach;" Randall G. Fisher, Thomas G. Boyce, Hugh L. Moffet; 2005.
- "Mosby's Pediatric Clinical Advisor: Instant Diagnosis and Treatment;" Lynn C. Garfunkel, Jeffrey Kaczorowski, Cynthia Christy; 2002.
- The Merck Manuals: Preseptal and Orbital Cellulitis
