• M C Durán-Giménez-Rico, A Boto-de-los-Bueis, M J Alberto, M J González-Iglesias, M I Gabarrón-Hermosilla, and J Abelairas-Gómez.
• Hospital San Rafael, Madrid, Spain.
• Arch Soc Esp Oftalmol. 2005 Sep 1;80(9):511-6.

PurposeTo evaluate retrospectively the response of preseptal and orbital cellulitis in children to empiric antibiotic treatment.MethodWe included nine patients (five male and four female) admitted to our hospital between October 2002 and October 2003 because of preseptal or orbital cellulitis.ResultsFour patients (44.4%) responded to empiric antibiotic treatment (R); five (55.5%) did not respond (NR) and required a second antibiotic to resolve the infection. The presence of an upper respiratory infection was the most common associated disease in both groups, R and NR. However we also found two cases of acute dacryocystitis in the NR. Four patients (44.4%) were treated with cefotaxime intravenously with the infection resolving in three of these. Five patients (55.6%) were treated with cefuroxime intravenously as first empiric option, however only one patient responded.ConclusionsWe found a high prevalence of acute dacryocystitis as a potential cause of the cellulitis. Children with preseptal and orbital cellulitis responded better to cefotaxime than to cefuroxime. The presence of acute dacryocystitis was associated with a lack of response to cefuroxime.

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