Spectrum: Local Antimicrobial Stewardship, for Alberta Children's Hospital

Periorbial Cellulitits (Sinusitis)

Note

Increased prevalence of community acquired MRSA.

Bacterial Pathogen

Streptococcus pneumoniae

Nontypeable Haemophilus influenzae

Staphylococcus aureus

Group A Streptococcus (Streptococcus pyogenes)

Duration of Therapy

10-14 days

First Line Therapy

Amoxicillin/Clavulanic acid 40-50 mg/kg per day divided tid

OR

Cefuroxime 20-30mg/kg per day divided BID

OR

Cefprozil 15-30 mg/kg per day divided bid

Alternatives (in Order)

Azithromycin (5d)
Day 1: 10 mg/kg per day
Day 2-5: 5 mg/kg per day q24h

OR

Clarithromycin 15 mg/kg per day divided bid

OR

Ceftriaxone 50 mg/kg per day IM/IV once a day