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Antibiotic prophylaxis and risk of orbital cellulitis following orbital floor fracture: a real-world evidence study using the TriNetX network.

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Title: Antibiotic prophylaxis and risk of orbital cellulitis following orbital floor fracture: a real-world evidence study using the TriNetX network.
Authors: Khan S; Ophthalmic Plastic Surgery, Lions Eye Institute, Department of Ophthalmology, Albany Medical College, Slingerlands, New York, USA., Simmons KL; Ophthalmic Plastic Surgery, Lions Eye Institute, Department of Ophthalmology, Albany Medical College, Slingerlands, New York, USA., Khan S; College of Medicine, Drexel University, Philadelphia, Pennsylvania, USA., Wladis EJ; Ophthalmic Plastic Surgery, Lions Eye Institute, Department of Ophthalmology, Albany Medical College, Slingerlands, New York, USA.
Source: Orbit (Amsterdam, Netherlands) [Orbit] 2026 Oct; Vol. 45 (5), pp. 645-649. Date of Electronic Publication: 2026 May 18.
Publication Type: Journal Article; Multicenter Study
Language: English
Journal Info: Publisher: Informa Healthcare Country of Publication: England NLM ID: 8301221 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1744-5108 (Electronic) Linking ISSN: 01676830 NLM ISO Abbreviation: Orbit Subsets: MEDLINE
Imprint Name(s): Publication: London : Informa Healthcare
Original Publication: Amsterdam : Aeolus Press, [1982-
MeSH Terms: Orbital Fractures*/surgery , Orbital Cellulitis*/prevention & control , Orbital Cellulitis*/epidemiology , Anti-Bacterial Agents*/therapeutic use , Antibiotic Prophylaxis*, United States/epidemiology ; Humans ; Retrospective Studies ; Female ; Male ; Middle Aged ; Incidence ; Adult ; Risk Factors ; Aged
Abstract: Purpose: To determine whether prophylactic antibiotic administration following the development of an orbital floor fracture or after orbital floor fracture repair is associated with a reduced risk of orbital or periorbital cellulitis.
Methods: A multicenter retrospective cohort study was designed using data obtained from the TriNetX United States Collaborative Network. Patients with orbital floor fractures were categorized by antibiotic exposure within 14 days of diagnosis. Similarly, patients who underwent orbital floor fracture repair were queried to determine whether or not they received antibiotics either at the time of surgery or in the immediate postoperative period. The primary outcome was orbital or periorbital cellulitis within 180 days, assessed after 1:1 propensity-score matching for demographic and clinical variables. Statistical analyses were then performed to determine differences in the two groups.
Results: Among 3,169 matched pairs, antibiotic use was associated with higher cellulitis incidence after incident orbital floor fracture (1.93% vs 0.57%, respectively; RR = 3.40, p < 0.0001). In 1,116 matched pairs who underwent orbital floor fracture repair, patients who received antibiotics were more likely to develop orbital cellulitis than those that did not (2.69% vs. 1.08%, respectively; RR = 2.50, 95% CI [1.29-4.86], p = 0.005).
Conclusion: Prophylactic antibiotics did not reduce infection risk after incident orbital floor fracture or after floor fracture repair and were associated with higher cellulitis rates. While clinical decision making may depend on a variety of factors, routine use of antibiotics in these settings may not be appropriate.
Contributed Indexing: Keywords: Orbital floor fracture; antibiotics; orbital cellulitis; periorbital cellulitis
Substance Nomenclature: 0 (Anti-Bacterial Agents)
Entry Date(s): Date Created: 20260518 Date Completed: 20260823 Latest Revision: 20260904
Update Code: 20260904
DOI: 10.1080/01676830.2026.2673568
PMID: 42151747
Database: MEDLINE
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PubType: Academic Journal
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  Data: Antibiotic prophylaxis and risk of orbital cellulitis following orbital floor fracture: a real-world evidence study using the TriNetX network.
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  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Khan+S%22&quot;&gt;Khan S&lt;/searchLink&gt;; Ophthalmic Plastic Surgery, Lions Eye Institute, Department of Ophthalmology, Albany Medical College, Slingerlands, New York, USA.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Simmons+KL%22&quot;&gt;Simmons KL&lt;/searchLink&gt;; Ophthalmic Plastic Surgery, Lions Eye Institute, Department of Ophthalmology, Albany Medical College, Slingerlands, New York, USA.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Khan+S%22&quot;&gt;Khan S&lt;/searchLink&gt;; College of Medicine, Drexel University, Philadelphia, Pennsylvania, USA.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Wladis+EJ%22&quot;&gt;Wladis EJ&lt;/searchLink&gt;; Ophthalmic Plastic Surgery, Lions Eye Institute, Department of Ophthalmology, Albany Medical College, Slingerlands, New York, USA.
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%228301221%22&quot;&gt;Orbit (Amsterdam, Netherlands)&lt;/searchLink&gt; [Orbit] 2026 Oct; Vol. 45 (5), pp. 645-649. &lt;i&gt;Date of Electronic Publication: &lt;/i&gt;2026 May 18.
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  Data: &lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Orbital+Fractures%22&quot;&gt;Orbital Fractures*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Orbital+Fractures+surgery%22&quot;&gt;surgery&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Orbital+Cellulitis%22&quot;&gt;Orbital Cellulitis*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Orbital+Cellulitis+prevention+%26+control%22&quot;&gt;prevention &amp; control&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Orbital+Cellulitis%22&quot;&gt;Orbital Cellulitis*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Orbital+Cellulitis+epidemiology%22&quot;&gt;epidemiology&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Anti-Bacterial+Agents%22&quot;&gt;Anti-Bacterial Agents*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Anti-Bacterial+Agents+therapeutic+use%22&quot;&gt;therapeutic use&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Antibiotic+Prophylaxis%22&quot;&gt;Antibiotic Prophylaxis*&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22United+States%22&quot;&gt;United States&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22United+States+epidemiology%22&quot;&gt;epidemiology&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Humans%22&quot;&gt;Humans&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Retrospective+Studies%22&quot;&gt;Retrospective Studies&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Female%22&quot;&gt;Female&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Male%22&quot;&gt;Male&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Middle+Aged%22&quot;&gt;Middle Aged&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Incidence%22&quot;&gt;Incidence&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Adult%22&quot;&gt;Adult&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Risk+Factors%22&quot;&gt;Risk Factors&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Aged%22&quot;&gt;Aged&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Purpose: To determine whether prophylactic antibiotic administration following the development of an orbital floor fracture or after orbital floor fracture repair is associated with a reduced risk of orbital or periorbital cellulitis.&lt;br /&gt;Methods: A multicenter retrospective cohort study was designed using data obtained from the TriNetX United States Collaborative Network. Patients with orbital floor fractures were categorized by antibiotic exposure within 14 days of diagnosis. Similarly, patients who underwent orbital floor fracture repair were queried to determine whether or not they received antibiotics either at the time of surgery or in the immediate postoperative period. The primary outcome was orbital or periorbital cellulitis within 180 days, assessed after 1:1 propensity-score matching for demographic and clinical variables. Statistical analyses were then performed to determine differences in the two groups.&lt;br /&gt;Results: Among 3,169 matched pairs, antibiotic use was associated with higher cellulitis incidence after incident orbital floor fracture (1.93% vs 0.57%, respectively; RR = 3.40, p &amp;lt; 0.0001). In 1,116 matched pairs who underwent orbital floor fracture repair, patients who received antibiotics were more likely to develop orbital cellulitis than those that did not (2.69% vs. 1.08%, respectively; RR = 2.50, 95% CI [1.29-4.86], p = 0.005).&lt;br /&gt;Conclusion: Prophylactic antibiotics did not reduce infection risk after incident orbital floor fracture or after floor fracture repair and were associated with higher cellulitis rates. While clinical decision making may depend on a variety of factors, routine use of antibiotics in these settings may not be appropriate.
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  Data: &lt;i&gt;Keywords: &lt;/i&gt;Orbital floor fracture; antibiotics; orbital cellulitis; periorbital cellulitis
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  Data: 0 (Anti-Bacterial Agents)
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  Data: &lt;i&gt;Date Created: &lt;/i&gt;20260518 &lt;i&gt;Date Completed: &lt;/i&gt;20260823 &lt;i&gt;Latest Revision: &lt;/i&gt;20260904
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/01676830.2026.2673568
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        StartPage: 645
    Subjects:
      – SubjectFull: United States epidemiology
        Type: general
      – SubjectFull: Humans
        Type: general
      – SubjectFull: Retrospective Studies
        Type: general
      – SubjectFull: Female
        Type: general
      – SubjectFull: Male
        Type: general
      – SubjectFull: Middle Aged
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      – SubjectFull: Incidence
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      – SubjectFull: Adult
        Type: general
      – SubjectFull: Risk Factors
        Type: general
      – SubjectFull: Aged
        Type: general
      – SubjectFull: Orbital Fractures surgery
        Type: general
      – SubjectFull: Orbital Cellulitis prevention & control
        Type: general
      – SubjectFull: Orbital Cellulitis epidemiology
        Type: general
      – SubjectFull: Anti-Bacterial Agents therapeutic use
        Type: general
      – SubjectFull: Antibiotic Prophylaxis
        Type: general
    Titles:
      – TitleFull: Antibiotic prophylaxis and risk of orbital cellulitis following orbital floor fracture: a real-world evidence study using the TriNetX network.
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            NameFull: Khan S
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            NameFull: Simmons KL
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            NameFull: Khan S
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            – D: 01
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              Text: 2026 Oct
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