Main Theme: General
Introduction:
Orbital cellulitis is an infection of tissues posterior to the orbital septum, most commonly arising from sinusitis in children. If untreated, it can lead to complications including cavernous sinus thrombosis, visual loss, and death. Although intravenous antibiotics remain the mainstay of treatment, the role of systemic corticosteroids is less well established. This two-cycle audit evaluated corticosteroid use in children with orbital cellulitis.
Methods:
A retrospective audit was conducted from January 2025 to April 2026 at the Royal Hospital for Children Glasgow. Paediatric patients with preseptal or orbital cellulitis were identified from handover lists. Clinical Portal and HEPMA records were reviewed to determine corticosteroid use, including steroid type, dose, route, and frequency.
Results:
The total patient population had a median age of 3.2 years, with a M:F gender ratio of 1.75:1. In cycle 1 (January–August 2025), 31 patients with preseptal or orbital cellulitis were identified. Six (19.4%) received systemic corticosteroids. Median length of stay was 5 days in the steroid group versus 2 days in the non-steroid group. Following protocol revision in November 2025 to consider corticosteroid use, cycle 2 (November 2025–April 2026) identified 24 patients, of whom four (16.7%) received steroids. Median length of stay was 4.5 days in the steroid group and 3 days in the non-steroid group.
Conclusion:
Systemic corticosteroids were used infrequently despite protocol revision. Further dissemination of the updated protocol and a third review are planned to assess uptake and support future evaluation of corticosteroid use in orbital cellulitis.