In this section
Typical presentation of periorbital/orbital cellulitis
Consider gonorrhoea and Chlamydia infections in neonatal presentation (send PCR swabs)
Bilateral findings and/or painless (or non-tender) swelling in a well looking child is more likely to be an allergic reaction.
Antimicrobial recommendations may vary according to local antimicrobial susceptibility patterns; please refer to local guidelines; these may include advice regarding community acquired MRSA
Inpatient investigations and management as per orbital cellulitis
Inpatient management or consider Hospital-in-the-home (HITH) admission if available locally
3rd generation cephalosporin
Flucloxacillin 50 mg/kg (max 2g) IV 6 hourly OR
If suspected MRSA: Vancomycin (see link for dosing)
Duration based on clinical severity and improvement. Usually at least
3-4 days, then switch to oral.
Amoxicillin with clavulanic acid (doses based on amoxicillin component) 22.5 mg/kg (max 875 mg) oral BD
Severe Periorbital cellulitis
Moderate Periorbital cellulitis
Flucloxacillin 50mg/kg (max 2g) IV 6 hourly
Ceftriaxone 50mg/kg (max 2g) IV daily (consider HITH)
If suspected MRSA:
Duration based on clinical severity and improvement. Usually 1-2 days,
then switch to oral.
Mild Periorbital cellulitis
For emergency advice and paediatric or neonatal ICU
transfers, see Retrieval
Last updated July, 2019