Orbital Cellulitis

Micro Organisms

Staph.aureus, Strep.pyogenes, Strep.pneumonia, Haemophilus spp.

First Line

Therapy

If less than 7 years old - Ceftriaxone IV + flucloxacillin IV for 5-7 days (Strep.pneumoniae more likely)

If 7 years and older - Ceftriaxone IV + flucloxacillin IV + metronidazole IV/PO for 5-7 days (mixed organisms / Strep.pyogenes more likely)

If MRSA suspected - switch flucloxacillin to vancomycin IV

Anaphylaxis (including severe skin reactions) to penicillin / cephalosporins

Therapy

Vancomycin IV + Clindamycin IV /PO +/- Gentamicin IV (if no improvement)

Notes

Contact ENT + Ophthalmology team as soon as the child is admitted