{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T23:08:59Z","timestamp":1784761739991,"version":"3.55.0"},"reference-count":40,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,4,13]],"date-time":"2020-04-13T00:00:00Z","timestamp":1586736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Periorbital cellulitis is a potential sight\u2010threatening complication of sinusitis. The majority of patients improve with medical management. Previous studies have suggested significant variations in practice and lack of evidence regarding the optimal management of this condition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective study was conducted over a 12\u2010month period at 8 centers in the United Kingdom assessing the management of patients requiring inpatient treatment for periorbital cellulitis secondary to sinonasal infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 143 patients were recruited, of whom 40 were excluded. Of the remaining 103 patients, 5 (4.9%) were diagnosed with neurosurgical complications. This resulted in 98 patients admitted with periorbital cellulitis secondary to an upper respiratory tract infection\/sinusitis. A total of 72 were children, of whom 12 (16.7%) required surgical intervention; and of 26 adults, 5 (19.2%) required surgery: the most common antimicrobial regimes administered were intravenous ceftriaxone (with or without metronidazole), and co\u2010amoxiclav. The use of both ceftriaxone and metronidazole from admission was associated with the shortest duration of inpatient stay (3.8 days) in comparison to ceftriaxone alone (5.8 days) or co\u2010amoxiclav (4.5 days) and a reduction in number of patients requiring surgical intervention. There was also an association between the early use of intranasal decongestants and steroids and reduction in requirement for surgical intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>For a condition where swab and blood cultures are often negative, this study supports the use of ceftriaxone in combination with metronidazole. The administration of intranasal decongestants and corticosteroids correlated with a smaller percentage of those progressing to surgery in those with and without periorbital abscesses.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.22535","type":"journal-article","created":{"date-parts":[[2020,4,13]],"date-time":"2020-04-13T15:41:38Z","timestamp":1586792498000},"page":"726-737","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["The management of periorbital cellulitis secondary to sinonasal infection: a multicenter prospective study in the United Kingdom"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5958-2322","authenticated-orcid":false,"given":"Sridhayan","family":"Mahalingam","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Frimley Park Hospital NHS Foundation Trust  Frimley UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Hone","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Brighton and Sussex University Hospitals NHS Trust, Royal Sussex County Hospital  Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gareth","family":"Lloyd","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery St George's University Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Grounds","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery East Kent Hospitals University NHS Foundation Trust  Ashford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eamon","family":"Shamil","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery University Hospital Lewisham  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gentle","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Evelina Hospital, Guy's and St Thomas\u2019 NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Al\u2010Lami","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Royal Surrey County Hospital  Guildford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anum","family":"Pervez","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Royal Surrey County Hospital  Guildford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Rudd","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Maidstone &amp; Tunbridge Wells NHS Trust  Royal Tunbridge Wells UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia Shin","family":"Poon","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Maidstone &amp; Tunbridge Wells NHS Trust  Royal Tunbridge Wells UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Riley","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery St George's University Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Hopkins","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Guy's and St Thomas\u2019 NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,4,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sjopt.2010.10.004"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-200110000-00017"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-197009000-00007"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(00)00242-6"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2273.2004.00889.x"},{"key":"e_1_2_7_7_1","unstructured":"BallS OkonkwoA PowellS CarrieS.ENT UK Revised Orbital Cellulitis Flow Chart 2017.https:\/\/www.entuk.org\/private-download\/ENT%20UK%20Revised%20Orbital%20Cellulitis%20Flow%20Chart%202017.pdf. 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