What is the best initial treatment for orbital cellulitis in children?

Abstract

Although antibiotics are the best initial treatment, surgical intervention is warranted when a child has: • visual impairment, complete ophthalmoplegia, or well-defined abscess on presentation, or • no clearly apparent clinical improvement by 24 hours (strength of recommendation [SOR]: C, based on patient-oriented case- series studies). Target antimicrobial therapy toward the common pathogens associated with pre- disposing factors for orbital cellulitis, such as sinusitis—and pay attention to local resistance patterns (SOR: C, based on patient-oriented case series).