Faculty Collaboration Database

Subperiosteal abscess of the orbit: duration of intravenous antibiotic therapy in nonsurgical cases. Ophthalmic Plast Reconstr Surg 2012;28(1):22-6

Date

10/01/2011

Pubmed ID

21956545

DOI

10.1097/IOP.0b013e31822ddddc

Scopus ID

2-s2.0-84856208981 (requires institutional sign-in at Scopus site)   27 Citations

Abstract

PURPOSE: To report the duration of intravenous (IV) antibiotic administration and outcomes in a cohort of patients with subperiosteal abscess (SPA) of the orbit triaged to nonsurgical management.

METHODS: A retrospective cohort study based on records of patients younger than 9 years admitted to a regional pediatric hospital with a diagnosis of orbital cellulitis from 1999 through 2008. Patients with computed tomography (CT)-confirmed SPA and associated sinusitis were included. Patients who underwent surgical drainage of sinuses and/or orbits during that admission were excluded. Patients discharged with a peripherally inserted central catheter for a predetermined treatment interval were excluded. Dates and times of first and last doses of inpatient IV antibiotics were recorded. Records were reviewed for evidence of hospital readmission for relevant diagnoses. Outcome measures included duration of IV antibiotic administration and hospital readmission.

RESULTS: Forty-two patients met study criteria. Duration of IV treatment ranged from 2 to 8 days (mean and median, each 4 days). Forty-one patients were not readmitted with a relevant diagnosis from the time of hospital discharge to completion of data acquisition in April 2011. One patient was readmitted for recurrent acute infection 10 weeks after discharge and underwent urgent SPA and sinus drainage; review of the initial CT revealed an ethmoidal mucocoele.

CONCLUSIONS: The duration of IV therapy associated with successful nonsurgical management of appropriately selected children with SPA is considerably shorter than that recommended in current pediatric infectious disease literature. The findings suggest that clinical judgment, based on each patient's initial CT findings and evolving signs, symptoms, and laboratory profile, should be a major determinant of IV intervals.

Author List

Emmett Hurley P, Harris GJ

Author

Gerald J. Harris MD Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Abscess
Anti-Bacterial Agents
Child
Child, Preschool
Cohort Studies
Female
Humans
Injections, Intravenous
Male
Orbital Diseases
Patient Readmission
Periosteum
Retrospective Studies
Time Factors