Ambulatory Intravenous Antibiotic Therapy for Children With Preseptal Cellulitis

Objective: This study aimed to compare the use of outpatient ambulatory care versus admission for intravenous antibiotics in the management of preseptal cellulitis. Methods: This is a retrospective consecutive cohort study of children younger than 16 years presenting to an Inner London Paediatric Emergency Department with signs and symptoms of preseptal cellulitis. Results: A total of 94 cases were identified during a 17-month period. Of them, 30 children were prescribed oral antibiotics. One child did not receive treatment. Of the 63 children prescribed with intravenous antibiotics, 42 were managed on an ambulatory basis and 21 were admitted. There was no significant difference in duration of treatment in days between those on ambulatory management and those admitted (2.79 +/- 0.8 vs 2.76 + 1.9, P = 0.94) or in the rate of complications. The net cost saving was $205,924 (131,065; pound (sic)147,578) overall, equal to $4900 (()3120; pound (sic)3513) per patient. Conclusions: Ambulatory intravenous antibiotics with daily review are a safe and cost-effective alternative to inpatient admission in simple preseptal cellulitis for children in our population who require parenteral antibiotics.