Streptococcus spp., Staphylococcus aureus
10 days but seek specialist advice
- Serious emergency – infection of soft tissue behind orbital septum.
- Contact specialist for advice if there is evidence of intracranial extension or if the patient has had surgery.
IV Ceftriaxone 2g 12 hourly
+ Oral Metronidazole 400mg 8 hourly (or IV 500mg 8 hourly if oral route not available)
For 10 days total treatment – if intracranial pathology excluded and patient responds well to IV, then switch after 3-5 days to
Oral Co-amoxiclav 625mg 8 hourly
IV Co-trimoxazole* 960mg 12 hourly
+ IV Clindamycin 300mg 6 hourly
For 10 days total treatment - If intracranial pathology excluded and patient responds well to IV, then switch after 3-5 days to
Oral Co-trimoxazole 960mg 12 hourly
+ Oral Clindamycin 300mg 6 hourly
*If IV Co-trimoxazole not available use IV Ciprofloxacin 400mg twice daily