Spectrum: Local Antimicrobial Stewardship, for IWK Health Centre

Periorbital cellulitis

Most likely pathogens

Duration of therapy

Usually 10-14 days but therapy can be continued for persistent cellulitis until eyelid swelling and erythema have resolved

Suggested regimen

Dosing is based on amoxicillin component:
Amoxicillin-Clavulanate 15-20 mg/kg/dose PO TID
Use 80 mg/mL suspension (7:1 formulation)

OR

Cefprozil 15 mg/kg/dose PO BID
Maximum: 1 gram/24h

For Moderate/Severe and/or Fever:

Ceftriaxone 50-75 mg/kg/dose IV q24h
Maximum: 2 grams/dose

Penicillin allergy

If the patient has NOT had a previous IgE mediated reaction to amoxicillin:
Cefprozil 15 mg/kg/dose PO BID
Maximum: 1 gram/24h

Penicillin allergy: Moderate/Severe and/or Fever

Ceftriaxone 50-75 mg/kg/dose IV q24h
Maximum: 2 grams/dose