As such, empiric therapy with vancomycin is their preferred first-line agent, along with cefotaxime and metronidazole or clindamycin for Gram-negative and anaerobic coverage.[ 33 ] In a study from the UK, empiric treatment with cefuroxime and metronidazole is suggested.[ 35 ] Chaudhry et al .[ 31 ] reported the use of cephalosporins and aminoglycosides as the commonest empiric therapy.[ 35 ] An increasing trend toward resistance to fluoroquinolones has been reported recently in one study.[ 7 ] The authors prefer to start empiric treatment in patients with orbital cellulitis with a combination of a third-generation cephalosporin like ceftriaxone and an aminoglycoside like amikacin.
1
—
—