Cost-Related Antibiotic Dosage Omissions—Challenge for Orbital Cellulitis Management in Resource Poor Communities

Abstract

Background: Orbital cellulitis is a medical emergency with potential vision and life threatening complications. Aim: To highlight clinical presentation and challenges in the management of orbital cellulitis in resource poor communities of southwestern Nigeria. Method: Retrospective review of patients managed for orbital cellulitis at the Wesley Guild Hospital, Ilesa, Nigeria for biodata, socioeconomic status, clinical presentation, compliance to prescribed medications and treatment outcome. Data was analyzed using SPSS version 11. Result: Seventeen patients with mean age and standard deviation of 10 ± 9.9 years were managed for orbital cellulitis. Thirteen (76.5%) females and 4(23.5%) males giving a male to female ratio of 1:3.3 (p = 0.03). Most patients (94.1%) belonged to low socioeconomic status and sinusitis was the most common predisposing factor. 10 (58.8%) had intravenous antibiotics only while 7(41.2%) had surgical drainage of abscess in addition. Delayed and irregular administration of antibiotics was observed in 9 (52.9%) patients due to lack of funds thus necessitating change of choice in antibiotics. Complication include ptosis 3(17.6%), corneal opacity 2 (11.8%), optic atrophy 1(5.9%) and 1(5.9%) meningitis and death 1(5.9%). Conclusion: Cost and affordability should be major determinants of choice of empirical antibiotics in resource poor communities to ensure timely and regular treatment and improve prognosis in management of orbital cellulitis.

Keywords:

• orbital cellulitis
• socioeconomic
• blindness
• antibiotics omission
• cost