{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T07:04:24Z","timestamp":1793862264825,"version":"4.6.1"},"reference-count":23,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,1]]},"abstract":"<jats:sec>\n                  <jats:title\/>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Standard treatment of children hospitalized for acute orbital cellulitis includes systemic antibiotics. Recent data from single-center studies suggest the addition of systemic corticosteroids may hasten clinical improvement and reduce hospital length of stay (LOS). We investigate the potential relationship between corticosteroid exposure and duration of hospitalization for pediatric orbital cellulitis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Using Pediatric Health Information System registry data from 51 children\u2019s facilities, we performed a retrospective cohort study of children hospitalized for orbital cellulitis &amp;lt;18 years of age from 2007 to 2018. The primary study outcome was hospital LOS. Secondary outcomes included frequency of surgical interventions, PICU admission, and 30-day related-cause readmission.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Of the 5645 children included for study, 1347 (24%) were prescribed corticosteroids within 2 days of admission. Corticosteroid prescription was not associated with LOS in analyses adjusted for age; presence of meningitis, abscess, or vision issues; and operative episode and PICU admission within 2 days (e\u03b2 = 1.01, 95% confidence interval [CI]: 0.97\u20131.06). Corticosteroid exposure was associated with operative episodes after 2 days of hospitalization (odds ratio = 2.05, 95% CI: 1.29\u20133.27) and 30-day readmission (odds ratio = 2.40, 95% CI: 1.52\u20133.78) among patients with a primary diagnosis of orbital cellulitis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In this database query, we were not able to detect a reduction in LOS associated with corticosteroid exposure during hospitalization for orbital cellulitis. Corticosteroid prescription was associated with PICU admission and operative episodes after 2 days of hospitalization. Before the adoption of routine corticosteroid use, prospective, randomized control trials are needed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2021-050677","type":"journal-article","created":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T08:30:14Z","timestamp":1635150614000},"source":"Crossref","is-referenced-by-count":16,"title":["Corticosteroids for Acute Orbital Cellulitis"],"prefix":"10.1542","volume":"148","author":[{"given":"Maria Anna","family":"Leszczynska","sequence":"first","affiliation":[{"name":"aDivisions of General Pediatrics and Adolescent Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony Alexander","family":"Sochet","sequence":"additional","affiliation":[{"name":"bPediatric Critical Care Medicine"},{"name":"cDepartments of Anesthesia and Critical Care Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anh Thy H.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"dDepartment of Health Informatics, Johns Hopkins All Children\u2019s Hospital, St Petersburg, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jazmine","family":"Mateus","sequence":"additional","affiliation":[{"name":"dDepartment of Health Informatics, Johns Hopkins All Children\u2019s Hospital, St Petersburg, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Michael","family":"Morrison","sequence":"additional","affiliation":[{"name":"ePediatric Hospital Medicine"},{"name":"fPediatrics, School of Medicine; Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2021,11,1]]},"reference":[{"issue":"4","key":"2022081818530099500_B1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1097\/00004397-200110000-00009","article-title":"Orbital cellulitis in children","volume":"41","author":"Jain","year":"2001","journal-title":"Int Ophthalmol Clin"},{"issue":"6","key":"2022081818530099500_B2","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1046\/j.1440-1606.1999.00242.x","article-title":"Current treatment and outcome in orbital cellulitis","volume":"27","author":"Ferguson","year":"1999","journal-title":"Aust N Z J Ophthalmol"},{"issue":"8","key":"2022081818530099500_B3","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1097\/01.inf.0000227820.36036.f1","article-title":"Orbital cellulitis in children","volume":"25","author":"Nageswaran","year":"2006","journal-title":"Pediatr Infect Dis J"},{"issue":"3","key":"2022081818530099500_B4","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/IOP.0000000000000910","article-title":"Intravenous steroids with antibiotics on admission for children with orbital cellulitis","volume":"34","author":"Chen","year":"2018","journal-title":"Ophthal Plast Reconstr Surg"},{"issue":"1","key":"2022081818530099500_B5","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.ajo.2013.01.031","article-title":"Role of oral corticosteroids in orbital cellulitis","volume":"156","author":"Pushker","year":"2013","journal-title":"Am J Ophthalmol"},{"issue":"5","key":"2022081818530099500_B6","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1097\/IOP.0000000000000349","article-title":"C-reactive protein as a marker for initiating steroid treatment in children with orbital cellulitis","volume":"31","author":"Davies","year":"2015","journal-title":"Ophthal Plast Reconstr Surg"},{"issue":"5","key":"2022081818530099500_B7","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1097\/01.iop.0000179973.44003.f7","article-title":"Effect of corticosteroids in the acute management of pediatric orbital cellulitis with subperiosteal abscess","volume":"21","author":"Yen","year":"2005","journal-title":"Ophthal Plast Reconstr Surg"},{"key":"2022081818530099500_B8","unstructured":"Children\u2019s Hospital Association\n          . PHIS description when referenced as a data source. 2020. Available at: https:\/\/www.childrenshospitals.org\/Member-Center\/Groups-Products\/PHIS\/Resources\/Research-Resources\/PHIS-Description- when-Referenced-as-a-Data-Source. Accessed March 12, 2020"},{"issue":"1","key":"2022081818530099500_B9","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1186\/1471-2431-14-199","article-title":"Pediatric complex chronic conditions classification system version 2: updated for ICD-10 and complex medical technology dependence and transplantation","volume":"14","author":"Feudtner","year":"2014","journal-title":"BMC Pediatr"},{"issue":"1","key":"2022081818530099500_B10","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1542\/hpeds.2017-0040","article-title":"Variation in care and clinical outcomes in children hospitalized with orbital cellulitis","volume":"8","author":"Markham","year":"2018","journal-title":"Hosp Pediatr"},{"issue":"8","key":"2022081818530099500_B11","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1002\/sim.1970","article-title":"Funnel plots for comparing institutional performance","volume":"24","author":"Spiegelhalter","year":"2005","journal-title":"Stat Med"},{"issue":"5","key":"2022081818530099500_B12","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1111\/pan.12374","article-title":"Dexamethasone, ondansetron, and their combination and postoperative nausea and vomiting in children undergoing strabismus surgery: a meta-analysis of randomized controlled trials","volume":"24","author":"Shen","year":"2014","journal-title":"Paediatr Anaesth"},{"issue":"7","key":"2022081818530099500_B13","doi-asserted-by":"crossref","first-page":"2193","DOI":"10.1007\/s00405-020-06294-z","article-title":"The role of adjuvant systemic steroids in the management of periorbital cellulitis secondary to sinusitis: a systematic review and meta-analysis","volume":"278","author":"Mahalingam","year":"2021","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"3","key":"2022081818530099500_B14","doi-asserted-by":"crossref","first-page":"115","DOI":"10.3109\/01676830.2014.950286","article-title":"Orbital cellulitis and subperiosteal abscess: a 5-year outcomes analysis","volume":"34","author":"Erickson","year":"2015","journal-title":"Orbit"},{"issue":"8","key":"2022081818530099500_B15","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.1016\/S0161-6420(00)00242-6","article-title":"Criteria for nonsurgical management of subperiosteal abscess of the orbit: analysis of outcomes 1988-1998","volume":"107","author":"Garcia","year":"2000","journal-title":"Ophthalmology"},{"issue":"6","key":"2022081818530099500_B16","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1097\/MOO.0b013e32834cd54a","article-title":"Management of pediatric orbital cellulitis and abscess","volume":"19","author":"Bedwell","year":"2011","journal-title":"Curr Opin Otolaryngol Head Neck Surg"},{"issue":"6","key":"2022081818530099500_B17","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1111\/j.1365-2273.2004.00889.x","article-title":"Guidelines for the management of periorbital cellulitis\/abscess","volume":"29","author":"Howe","year":"2004","journal-title":"Clin Otolaryngol Allied Sci"},{"key":"2022081818530099500_B18","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.ijporl.2018.05.006","article-title":"Management of pediatric orbital cellulitis: a systematic review","volume":"110","author":"Wong","year":"2018","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"2","key":"2022081818530099500_B19","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.ajo.2014.04.022","article-title":"Predicting the need for surgical intervention in pediatric orbital cellulitis","volume":"158","author":"Smith","year":"2014","journal-title":"Am J Ophthalmol"},{"issue":"6","key":"2022081818530099500_B20","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/S1091-8531(98)90033-7","article-title":"Medical treatment of pediatric subperiosteal orbital abscess secondary to sinusitis","volume":"2","author":"Greenberg","year":"1998","journal-title":"J AAPOS"},{"issue":"3","key":"2022081818530099500_B21","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1002\/lary.25529","article-title":"Characteristics of patients treated for orbital cellulitis: an analysis of inpatient data","volume":"126","author":"Marchiano","year":"2016","journal-title":"Laryngoscope"},{"issue":"6","key":"2022081818530099500_B22","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.jaapos.2003.09.013","article-title":"Intracranial infection associated with preseptal and orbital cellulitis in the pediatric patient","volume":"7","author":"Reynolds","year":"2003","journal-title":"J AAPOS"},{"issue":"3","key":"2022081818530099500_B23","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1016\/j.jpeds.2010.09.011","article-title":"Intraorbital and intracranial extension of sinusitis: comparative morbidity","volume":"158","author":"Goytia","year":"2011","journal-title":"J Pediatr"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2021-050677\/1353967\/peds_2021050677.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2021-050677\/1353967\/peds_2021050677.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T18:54:49Z","timestamp":1660848889000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/148\/5\/e2021050677\/181343\/Corticosteroids-for-Acute-Orbital-Cellulitis"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,1]]},"references-count":23,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,11,1]]},"published-print":{"date-parts":[[2021,11,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2021-050677","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,1]]},"article-number":"e2021050677"}}