Patients at low risk of MRSA infection

For patients with periorbital cellulitis who are systemically well and have concurrent sinusitis or risk factors for Hib infection (eg children younger than 5 years who are not fully vaccinated) and who are at low risk of MRSA infection (see Risk factors for infection with methicillin-resistant Staphylococcus aureus), use:

1amoxicillin+clavulanate 875+125 mg (child 2 months or older: 22.5+3.2 mg/kg up to 875+125 mg) orally, 12-hourly. For dosage adjustment in adults with kidney impairment, see amoxicillin+clavulanate oral dosage adjustment. See advice on patient review, and modification and duration of therapy amoxicillin + clavulanate amoxicillin+clavulanate amoxicillin+clavulanate

OR

2cefuroxime 500 mg (child 3 months or older: 15 mg/kg up to 500 mg) orally, 12-hourly. For dosage adjustment in adults with kidney impairment, see cefuroxime dosage adjustment. See advice on patient review, and modification and duration of therapy. cefuroxime cefuroxime cefuroxime

For patients who have had a nonsevere (immediate or delayed) hypersensitivity reaction to a penicillin, use the cefuroxime regimen above.

For patients who have had a severe (immediate or delayed)1 hypersensitivity reaction to a penicillin, use trimethoprim+sulfamethoxazole (see Patients at increased risk of MRSA infection for dosages).

1 Severe immediate hypersensitivity reactions include anaphylaxis, compromised airway, airway angioedema, hypotension and collapse. Severe delayed hypersensitivity reactions include cutaneous adverse drug reactions (eg drug rash with eosinophilia and systemic symptoms [DRESS], Stevens–Johnson syndrome/toxic epidermal necrolysis [SJS/TEN], severe blistering or desquamative rash), and significant internal organ involvement (eg acute interstitial nephritis).Return