Our experience using primary oral antibiotics in the management of orbital cellulitis in a tertiary referral centre

Our experience using primary oral antibiotics in the management of orbital cellulitis in a tertiary referral centre

Eye. 2008 Feb 29

Cannon PS, Keag DM, Radford R, Ataullah S, Leatherbarrow B.
1Oculoplastic and Orbit Department, Manchester Royal Eye Hospital, Oxford Road, Manchester, UK.

Correspondence: PS Cannon, Oculoplastic and Orbit Department, Manchester Royal Eye Hospital, Oxford Road, Manchester M13 WH, UK. Tel: +0044 161 276 5565; Fax: +0044 161 272 6618; E-mail: pscan05@yahoo.co.uk

Aims/PurposeOrbital cellulitis is conventionally managed by intravenous (i.v.) antibiotic therapy, followed by oral antibiotics once the infection shows signs of significant improvement. We report 4 years of experience using primary oral ciprofloxacin and clindamycin in cases of orbital cellulitis. Oral ciprofloxacin and clindamycin have a similar bioavailability to the i.v. preparations and provide an appropriate spectrum of antibiotic cover for the pathogens responsible for orbital cellulitis.MethodsA retrospective review was performed that identified all patients with orbital cellulitis and treated with primary oral antibiotic therapy admitted to the Manchester Royal Eye Hospital between March 2003 and March 2007. Age, stage of disease, surgical intervention, hospital duration, and complications were obtained. A comparison was made with patients admitted to our unit with orbital cellulitis and treated with primary i.v. antibiotics between March 2000 and March 2003.ResultsNineteen patients were included in the review for the period March 2003 to March 2007, which comprised of 7 children and 12 adults. Five patients required surgical intervention. All patients responded to the oral regimen, 18 patients had no change to their oral antibiotic therapy. Mean hospital stay was 4.4 days. There were no complications.DiscussionEmpirical oral ciprofloxacin and clindamycin combination may be as safe and effective as i.v. therapy in the management of orbital cellulitis. Oral treatment can offer the advantages of rapid delivery of the first antibiotic dose, fewer interruptions in treatment, and simplified delivery of medication particularly in children.

Eye advance online publication, 29 February 2008; doi:10.1038/eye.2008.44.

Nature