{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T06:06:23Z","timestamp":1789193183937,"version":"build-2803163510"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T00:00:00Z","timestamp":1650326400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32HD055148"],"award-info":[{"award-number":["T32HD055148"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,30]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The epidemiology of orbital cellulitis likely has evolved due to the emergence of methicillin-resistant Staphylococcus aureus (MRSA) and the adoption of pneumococcal conjugate vaccination. In the absence of published guidelines, management is highly variable. We characterized epidemiology and management over an 11-year period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study of children 0 to 21 years of age with orbital cellulitis +\/\u2212 subperiosteal orbital abscess hospitalized at a large quaternary children\u2019s hospital from January 2008 to June 2018. We reviewed charts for demographic characteristics, clinical features, management, and outcomes. Using multivariable logistic regression, we evaluated predictors of surgical intervention and assessed whether corticosteroid use or antibiotic duration was related to clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 220 patients, methicillin-susceptible S. aureus was the most common organism (26.3%), with MRSA found in only 5.0%. Rates of vancomycin use fluctuated annually from 40.9% to 84.6%. Surgery was performed in 39.5% of the patients. Corticosteroids, used in 70 patients (32.1%), were unrelated to treatment failure (n = 9), defined as persistent signs and symptoms or initial clinical improvement followed by worsening (P = .137). The median antibiotic duration was 17 days (interquartile range 14-26). After controlling for age, gender, proptosis, eye pain with movement, eyelid swelling, neutrophil count, and corticosteroid use, treatment failure was not significantly associated with receipt of \u2265 3 weeks of antibiotic therapy (8\/84, 9.5%) compared with &amp;gt; 2 but &amp;lt; 3 weeks (0\/51, 0.0%) or \u2264 2 weeks (1\/85, 1.2%) (adjusted odds ratio = 5.83 for \u2265 3 vs \u22642 weeks; 95% confidence interval: 0.58, 59.0).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although MRSA was rare, empiric vancomycin use was high. Treatment failure was uncommon in patients who received \u2264 2 weeks of therapy, suggesting that shorter durations are adequate in some patients.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jpids\/piac006","type":"journal-article","created":{"date-parts":[[2022,2,5]],"date-time":"2022-02-05T12:08:32Z","timestamp":1644062912000},"page":"214-220","source":"Crossref","is-referenced-by-count":58,"title":["Epidemiology and Management of Orbital Cellulitis in Children"],"prefix":"10.1093","volume":"11","author":[{"given":"Brenda I","family":"Anosike","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Pediatrics, Boston Children\u2019s Hospital , Boston, Massachusetts , USA"},{"name":"Department of Pediatrics, Harvard Medical School , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veena","family":"Ganapathy","sequence":"additional","affiliation":[{"name":"Medical College of Georgia , Augusta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari M","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Pediatrics, Boston Children\u2019s Hospital , Boston, Massachusetts , USA"},{"name":"Department of Pediatrics, Harvard Medical School , Boston, Massachusetts , USA"},{"name":"Antimicrobial Stewardship Program, Boston Children\u2019s Hospital , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,4,19]]},"reference":[{"key":"2022060104560991800_CIT0001","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/B978-0-7020-3468-8.50095-X","article-title":"Periorbital and orbital infections.","volume-title":"Principals and Practice of Pediatric Infectious 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