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To the Editor.—In regard to the article by Watters et al, "Acute Orbital Cellulitis," which appeared in the May 1976 issue of the Archives (94:785-788, 1976), I wish to bring to the attention of other ophthalmologists that Haemophilus influenzae type b represents a very common cause of orbital cellulitis as well as other life-threatening illnesses such as meningitis and epiglottitis. Prior to 1971 almost all strains of H influenzae type b were sensitive to ampicillin, but since then, an increasing number have been found to be resistant to it. Currently, to treat children who are suspected of having a life-threatening disease that is potentially due to H influenzae with chloramphenicol (100 mg/kg/day) is considered good pediatric practice until the physician is certain that the organism is sensitive to ampicillin, at which time therapy may be continued with chloramphenicol or altered to ampicillin. This therapeutic approach includes children with suspected
Gutman L. Appropriate Antibiotics in Orbital Cellulitis. Arch Ophthalmol. 1977;95(1):170. doi:10.1001/archopht.1977.04450010170030