From the Research
Augmentin (amoxicillin/clavulanic acid) is more likely to cover common pathogens of orbital cellulitis compared to clindamycin. For empiric treatment of orbital cellulitis in adults, a typical regimen would be Augmentin 875/125 mg orally twice daily for 7-10 days, as supported by the most recent study 1. Augmentin provides broader coverage against both Gram-positive and Gram-negative bacteria commonly implicated in orbital cellulitis, including Staphylococcus aureus, Streptococcus species, and Haemophilus influenzae. While clindamycin is effective against many Gram-positive bacteria and anaerobes, it lacks coverage for some important Gram-negative pathogens like H. influenzae, as noted in studies 2, 3, 4.
Some key points to consider when choosing an antibiotic regimen for orbital cellulitis include:
- The most common pathogens involved, such as Staphylococcus aureus, Streptococcus species, and Haemophilus influenzae
- The potential for antibiotic resistance, particularly in cases of suspected methicillin-resistant S. aureus (MRSA)
- The need for broad-spectrum coverage, including both Gram-positive and Gram-negative bacteria
- The importance of prompt evaluation by an ophthalmologist or otolaryngologist, especially in severe cases that may require intravenous antibiotics and surgical intervention
It's also worth noting that clindamycin may be considered as an alternative in cases of suspected MRSA or in patients with penicillin allergy, as suggested by studies 3, 5. However, Augmentin's combination of amoxicillin and clavulanic acid allows it to overcome certain bacterial resistance mechanisms, making it a more versatile choice for empiric therapy. Ultimately, the choice of antibiotic should be guided by the most recent and highest-quality evidence, as well as consideration of individual patient factors and the specific clinical context.