Treatment of Orbital Cellulitis When Methicillin-Resistant Staphylococcus aureus (MRSA) Infection Is Suspected

Clinical scenario

This protocol addresses orbital cellulitis in cases where methicillin-resistant Staphylococcus aureus (MRSA) is a suspected causative organism. The possibility of MRSA changes the empiric antibiotic strategy compared to standard orbital cellulitis management.

Approach (partial overview)

Empiric intravenous antibiotic therapy with activity against MRSA is a key component, combined with agents that extend coverage to other potential organisms. The complete selection, dosing, and combination strategy are detailed in the full protocol.

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References

DOI: 10.1016/j.survophthal.2017.12.001

In cases that MRSA is suspected, vancomycin is administered.
Specifically, empiric use of vancomycin is recommended, based on the reported increased incidence of CA-MRSA infections.
They also advocate use of cefotaxime and metronidazole or clindamycin, to provide concurrent coverage against gram-negative and anaerobic organisms.

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