University of Wisconsin–Madison Medical College of Wisconsin

Pediatric Orbital Cellulitis/Abscess: Microbiology and Pattern of Antibiotic Prescribing

Alina G. Burek, MD; Geanina Tregoning, DO; Amy Pan, PhD; Melodee Liegl, MA; Gerald J. Harris, MD; Peter L. Havens, MD, MS

WMJ. 2023;122(1):52-55.

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Background: The treatment for pediatric orbital cellulitis/abscess is trending towards intravenous antibiotic management alone in appropriate cases. Without cultures to guide therapy, knowing the local microbiology is of utmost importance in managing these patients.

Methods: We conducted a retrospective case series for patients age 2 months to 17 years, who were hospitalized between January 1, 2013, and December 31, 2019, to evaluate the local microbiology and pattern of antibiotic prescribing in pediatric orbital cellulitis.

Results and Discussion: Of 95 total patients, 69 (73%) received intravenous antibiotics only and 26 (27%) received intravenous antibiotics plus surgery. The most common organism cultured was Streptococcus anginosus, followed by Staphylococcus aureus, and group A streptococcus. Methicillin-resistant Staphylococcus aureus (MRSA) prevalence was 9%. MRSA-active antibiotics remain the most frequently used antibiotics.

Author Affiliations: Children’s Wisconsin, Milwaukee, Wisconsin (Burek, Tregoning, Harris, Havens); Department of Pediatrics, Medical College of Wisconsin (MCW), Milwaukee, Wis (Burek, Tregoning, Pan, Liegl, Havens); Department of Ophthalmology and Visual Sciences, MCW, Milwaukee, Wis (Harris).
Corresponding Author: Alina Burek, Department of Pediatrics, Section of Hospital Medicine, Medical College of Wisconsin, Children’s Corporate Center C 560, 999 North 92nd St, Milwaukee, Wisconsin 53226; phone 414.337.7050; email; ORCID ID 0000-0001-9978-2505
Funding/Support: Dr Burek received internal funding from Medical College of Wisconsin Department of Pediatrics for this study.
Financial Disclosures: None declared.
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