Systemic steroids may not reduce hospital length of stay in acute orbital cellulitis: Study

Standard treatment of children hospitalized for acute orbital cellulitis includes systemic antibiotics. Recent data from single-centre studies suggest the addition of systemic corticosteroids may hasten clinical improvement and reduce hospital length of stay (LOS).

A group of researchers conducted a study to investigate the potential relationship between corticosteroid exposure and duration of hospitalization for pediatric orbital cellulitis.

Using Pediatric Health Information System registry data from 51 children's facilities, we performed a retrospective cohort study of children hospitalized for orbital cellulitis <18 years of age from 2007 to 2018. The primary study outcome was hospital length of stay (LOS). Secondary outcomes included frequency of surgical interventions, PICU admission, and 30-day related-cause readmission.

The results of the study are as follows:

• Of the 5645 children included in the study, 1347 (24%) were prescribed corticosteroids within two days of admission.
• Corticosteroid prescription was not associated with hospital length of stay (LOS) in analyses adjusted for age; the presence of meningitis, abscess, or vision issues; and operative episode and PICU admission within 2 days
  
• Corticosteroid exposure was associated with operative episodes after 2 days of hospitalization and 30-day readmission among patients with a primary diagnosis of orbital cellulitis.

Therefore, the researchers concluded that in this database query, we were not able to detect a reduction in hospital length of stay (LOS) associated with corticosteroid exposure during hospitalization for orbital cellulitis. Corticosteroid prescription was associated with PICU admission and operative episodes after 2 days of hospitalization. Before the adoption of routine corticosteroid use, prospective, randomized control trials are needed.

Reference:

A study named, "Corticosteroids for Acute Orbital Cellulitis"by Maria Anna Leszczynska et al. published in the Pediatrics.

DOI: https://doi.org/10.1542/peds.2021-050677