Orbital cellulitis requires prompt empirical intravenous antibiotic therapy as a first step. When clinical improvement and resolution of fever do not occur within 24–36 hours of starting that regimen, the treatment approach must be escalated.
The initial regimen — empirical IV antibiotics including ceftriaxone and flucloxacillin, with adjunctive systemic corticosteroids and nasal hygiene — did not achieve clinical improvement of orbital cellulitis and absence of pyrexia within 24–36 hours of starting treatment. This protocol addresses the next step after that failure.
When the expected response to the initial antibiotic regimen is not seen, additional coverage targeting a specific bacterial group is added to the existing treatment. The structured protocol defines which agents are appropriate and under what circumstances — the complete regimen is available via the link below.
DOI: 10.1016/j.survophthal.2017.12.001