From the Research
Preseptal cellulitis should be treated with antibiotics targeting common causative organisms like Staphylococcus aureus and Streptococcus species, with a focus on optimizing pharmacodynamic target attainment and minimizing antibiotic duration to approximately 2 weeks, as recommended by recent studies 1.
Treatment Options
- For mild to moderate cases, oral antibiotics are the first-line treatment, with options including:
- Amoxicillin-clavulanate (875/125 mg twice daily for adults, 45 mg/kg/day divided twice daily for children) for 7-10 days
- Cephalexin (500 mg four times daily for adults, 25-50 mg/kg/day divided four times daily for children)
- For patients with penicillin allergies, clindamycin (300-450 mg four times daily for adults, 30-40 mg/kg/day divided three times daily for children) or trimethoprim-sulfamethoxazole may be used
Severe Cases
- Severe cases, especially those with systemic symptoms, significant swelling, or in immunocompromised patients, require hospitalization for intravenous antibiotics such as:
- Ampicillin-sulbactam
- Ceftriaxone
- Vancomycin (if MRSA is suspected)
Additional Measures
- Warm compresses applied to the affected area for 15-20 minutes several times daily can help reduce inflammation
- Patients should be monitored closely for signs of progression to orbital cellulitis (decreased eye movement, vision changes, proptosis), which is a medical emergency
- The infection typically responds to antibiotics within 24-48 hours, but the full course must be completed to prevent recurrence and complications, with a focus on antimicrobial stewardship programs to optimize treatment and minimize duration 1, 2