**Author details**

Preseptal cellulitis treatment is based on oral antibiotics (outpatient treatment) and antisep‐ tic treatment locally provided that a close follow-up can be ensured. Hospitalization is rec‐ ommended if there is no improvement within 48 hours (or even 24 hours), and parenterally antibiotics (broad-spectrum intravenous antibiotics) are necessary once appropriate cultures have been obtained, undergoing a CT scan to evaluate for orbital cellulitis and its complica‐ tions. Patients with subtle clinical and/or radiographic findings, suggesting that the orbit is involved, should be treated as a case of orbital cellulitis given the serious complications of

Also, children younger than one year of age, those who cannot cooperate fully, and patients who are severely ill should generally be admitted to the hospital and managed according to

Teenagers and adults usually respond quickly to appropriate oral antibiotics and there is no need for hospitalization unless orbital involvement cannot be excluded or when the clinical

Initial antibiotic selection is based on the history, clinical findings and laboratory studies, and is almost always empiric and based upon knowledge of the common infecting organ‐ isms. Staphylococcus aureus is the most common pathogen in patients with preseptal cellu‐ litis resulting from trauma. The infection usually responds quickly to penicillinase-resistant penicillin. Third-generation cephalosporins or ampicillin have both a broad spectrum cover‐ age including activity against Haemophilusinfluenza, and should be initiated immediately

Lid abscesses should be drained surgically with the incision and drainage usually per‐

In order to avoid contamination of the orbital soft tissue, the orbital septum should not be

One of the following regimens is suggested for empiric oral treatment of preseptal cellulitis:

**•** Clindamycin (in children: 30 to 40 mg/kg per day in three to four equally divided doses, not to exceed 1.8 grams per day; in adults: 300 mg every eight hours) as monotherapyor

**•** Trimethoprim-sulfamethoxazole (TMP-SMX; in children: 8 to 12 mg/kg per day of the tri‐ methoprim component divided every 12 hours; in adults: 8 mg/kg per day of the trime‐

**•** Amoxicillin (in children: 80 to 100 mg/kg per day in divided doses every eight hours; in

**•** Amoxicillin-clavulanic acid (in children: 45 mg/kg per day divided every 12 hours; in

**•** Cefpodoxime (in children: 10 mg/kg per day divided every 12 hours, not to exceed 200

formed directly over the abscess, avoiding the damage of the levatoraponeurosis.

thoprim component divided every 8 or 12 hours) plus one of the following:

this entity.

118 Common Eye Infections

the recommendations.

situation is severe.

after obtaining the cultures.

adults: 875 mg orally every 12 hours) or

mg per dose; in adults: 400 mg every 12 hours) or

adults: 875 mg every 12 hours) or

opened.

[39]

Monika Fida1 , Kocinaj Allma2 , Abazi Flora2 and Arjeta Grezda1

1 University Hospital Center "Mother Teresa", Tirana, Albania

2 University Clinical Center of Kosova, Prishtina, Kosovo
