Audit of management of periorbital cellulitis and abscess in a district general hospital and a tertiary referral centre, in line with published guidelines.
OBJECTIVE
To audit the management of periorbital cellulitis or abscess, in line with guidelines published in 2004, within a district general hospital and a tertiary referral centre.


METHODS
Retrospective audit analysing 58 cases at a district general hospital and 61 cases at a tertiary referral centre, encountered since 2004.


RESULTS
At the tertiary referral centre, 22 patients were diagnosed with pre-septal cellulitis and discharged, as were 20 cases at the district general hospital. At the tertiary referral centre, 95 per cent of patients were correctly seen by an ophthalmologist and 82 per cent by a senior ENT surgeon, compared with 63 and 39 per cent, respectively, at the district general hospital. In both centres, one patient did not receive a computed tomography scan where this was indicated. Despite the need for twice daily monitoring of ophthalmological criteria, both sites lacked 100 per cent compliance. At the tertiary referral centre, 76 per cent of patients were correctly treated with intravenous antibiotics, compared with 68 per cent at the district general hospital.


CONCLUSIONS
At both sites, adherence to guidelines was suboptimal. Management may be improved through improved education and online information support.
Dhillon
Neeru
N
ENT Department, Kings Mill Hospital, Mansfield, UK. neerudhillon@hotmail.com
Jones
N
N
Fergie
N
N
D000038:Abscess / Q000175:diagnosis / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D054869:Clinical Audit; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000628:therapy; D019983:Guideline Adherence; D006767:Hospitals, District / Q000592:standards; D006769:Hospitals, General / Q000592:standards; D006801:Humans; D009885:Ophthalmology / Q000592:standards; D054517:Orbital Cellulitis / Q000175:diagnosis / Q000628:therapy; D010036:Otolaryngology / Q000592:standards; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents