Children with community-acquired serious otolaryngologic
infections are conventionally hospitalized for parenteral
antibiotic therapy. However, effective and safe outpatient
therapy is desirable since it is less traumatic and less costly. During a 24-month period outpatient parenteral
antibiotic therapy, usually once daily i.m.
ceftriaxone, was evaluated in 41 children with serious otolaryngologic
infections (acute
mastoiditis, complicated
otitis media, severe
external otitis and severe
sinusitis with orbital or periorbital involvement). Daily visits and compliant capable parents were considered essential for outpatient management. Diagnosis, plan for management and daily follow-up evaluations were carried out in cooperation by otolaryngology and
infectious disease specialists. Nineteen children (45%) were treated initially in the hospital and 22 children (55%) were treated entirely as outpatients. The mean duration of outpatient treatment, using once daily i.m.
ceftriaxone was 5.7 days (range 1-13). The overall clinical cure rate was 98% and no serious side effects were observed. One case of
sinusitis-
orbital cellulitis relapsed during
therapy. Most patients and parents returned to normal life activities within 72 h from starting outpatient
therapy. Our data suggest that many children with serious otolaryngologic
infections can be managed successfully and safely as outpatients by a combined team of otolaryngology and
infectious disease specialists.