First-Line Treatment for Orbital Cellulitis
In orbital cellulitis, treatment must be started promptly. The approach combines intravenous antibiotic therapy with adjunctive measures, and early clinical response is assessed against defined targets within hours of initiating therapy.
Treatment Approach
Management centres on prompt empirical intravenous antibiotic therapy incorporating a broad-spectrum combination, alongside adjunctive systemic and local components — the complete regimen, sequencing, and all additional details are set out in the full protocol.
Clinical Target
Clinical improvement and absence of pyrexia within 24–36 hours of starting treatment.
References
- A well-accepted proposed treatment scheme includes a broad spectrum antibiotic, specifically a third generation cephalosporin such as ceftriaxone with flucloxacillin.
- Duration of antibiotic treatment varies from 1 to 2 weeks intravenously, followed by oral treatment in order to complete a 4-week regimen.
- Adjunctive use of corticosteroids is considered favorable together with the appropriate antibiotics, in the management of OC particularly after clinical improvement is noted.
- Finally, it is important that simultaneous sinusitis is treated, along with medical treatment of OC, with aggressive nasal hygiene, decongestants, saline nasal irrigation, and intranasal corticosteroids.
- Coverage for anaerobic bacteria is initiated in cases where there is no clinical improvement or in case of pyrexia after 24-36 hours after initiation of treatment.
DOI: 10.1016/j.survophthal.2017.12.001
View source ↗