Cost-related antibiotic dosage omissions-challenge for orbital cellulitis management in resource poor communities.
BACKGROUND
Orbital cellulitis is a medical emergency with potential vision and life threatening complications.


OBJECTIVE
To highlight clinical presentation and challenges in the management of orbital cellulitis in resource poor communities of southwestern Nigeria.


METHODS
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.


RESULTS
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%).


CONCLUSIONS
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.
Department of Surgery, Obafemi Awolowo University, Ile Ife, Nigeria. uvtoyin2@yahoo.co.uk
Oluwatoyin Helen
OH
Onakpoya
Adenike O
AO
Adeoye
Olubunmi V
OV
Akinpelu
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000191:economics*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017281:Cost of Illness; D003906:Developing Countries; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D016527:Drug Costs; D004359:Drug Therapy, Combination / Q000191:economics; D005260:Female; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous / Q000191:economics; D008297:Male; D009549:Nigeria; D054517:Orbital Cellulitis / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics; D011203:Poverty; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D055815:Young Adult
D000900:Anti-Bacterial Agents