Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Department of Otolaryngology, McGill University, Montreal, Quebec, Canada.
Clin Otolaryngol. 2019 May;44(3):273-278. doi: 10.1111/coa.13284. Epub 2019 Feb 6.
To evaluate whether outpatient treatment of periorbital cellulitis with daily administration of intravenous antibiotics and physician evaluation is an effective and safe alternative to admission.
A retrospective chart review study of paediatric patients treated on an outpatient basis for periorbital cellulitis at a tertiary children's hospital between 2013 and 2015 was performed. Children were assessed day by a paediatrician to monitor for resolution of symptoms or complications.
The Montreal Children's hospital, a tertiary care centre.
Children diagnosed with an uncomplicated periorbital cellulitis secondary to an acute sinusitis or upper respiratory tract infection.
The number of days of intravenous antibiotics, complications or need for subsequent admission. Complications were defined as formation of an abscess or phlegmon confirmed on computerised tomography scan, worsening or recurrent persistent cellulitis, failure to improve on intravenous antibiotics, and intracranial complications.
Sixty-six children with a diagnosis of uncomplicated periorbital cellulitis secondary to sinusitis who received intravenous antibiotics via medical day hospital and who fit the inclusion criteria were identified. The mean duration of intravenous antibiotic therapy was 4.1 days. All children received ceftriaxone, with one patient also receiving cefuroxime. Two of 66 patients developed complications; one patient required admission for failure to improve/subperiosteal phlegmon and later underwent functional endoscopic sinus surgery, and one patient developed an eyelid abscess that did not require admission. No patients developed severe neurological or visual deficits.
Outpatient intravenous therapy with daily reassessment by a physician may be a safe alternative to admission in select cases of periorbital cellulitis without systemic signs of illness.
评估对于眶周蜂窝织炎患者，采用每日静脉注射抗生素和医生评估的门诊治疗是否是一种替代住院的有效且安全的方法。
对 2013 年至 2015 年期间在一家三级儿童医院接受门诊治疗眶周蜂窝织炎的儿科患者进行回顾性图表研究。每天由儿科医生评估患儿，以监测症状或并发症是否缓解。
蒙特利尔儿童医院，一家三级保健中心。
诊断为急性鼻窦炎或上呼吸道感染引起的单纯性眶周蜂窝织炎的儿童。
静脉用抗生素的天数、并发症或后续住院的需求。并发症定义为计算机断层扫描（CT）扫描证实的脓肿或蜂窝织炎形成、恶化或复发性持续蜂窝织炎、静脉用抗生素治疗无效以及颅内并发症。
共确定了 66 例患有急性鼻窦炎继发的单纯性眶周蜂窝织炎、符合纳入标准且接受静脉抗生素治疗的儿童。静脉抗生素治疗的平均持续时间为 4.1 天。所有患儿均接受头孢曲松治疗，1 例患儿还接受头孢呋辛治疗。66 例患儿中有 2 例发生并发症；1 例因治疗无效/骨膜下蜂窝织炎而需住院治疗，后行功能性内镜鼻窦手术，1 例患儿发生眼睑脓肿但无需住院治疗。无患儿发生严重神经或视力缺陷。
对于无全身疾病迹象的眶周蜂窝织炎患者，采用每日由医生重新评估的门诊静脉治疗可能是替代住院的安全方法。
