Warning

Orbital Cellulitis

Seek immediate specialist advice from Ophthalmology and Microbiology.

Recommended antibiotics

Ceftriaxone 2g IV 12 hourly

+

Metronidazole IV 500mg 8 hourly or, if oral route available, 400mg oral 8 hourly

If history of cephalosporin allergy or anaphylactic/Type 1 penicillin hypersensitivity

Vancomycin IV (dosing as per guideline. Use vancomycin calculator).

+

Metronidazole IV 500mg 8 hourly or, if oral route available, 400mg oral 8 hourly

+

Gentamicin (standard dosing as per guideline. Use gentamicin calculator)

Editorial Information

Last reviewed: 20/07/2025

Next review date: 20/07/2028

Author(s): Duguid, A.

Version: 2.0

Co-Author(s): James, E, Longworth, E, Taylor, J.

Approved By: NHS Borders Antimicrobial Management Team

Reviewer name(s): Duguid, A.