[Antibiotherapy of severe ENT infections in children: complicated sinusitis].

Intra or extra orbital cellulitis or abscesses are the most frequent bacterial complications of acute sinusitis. Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus (SA), and anaerobic bacteria are predominant, and more rarelyHaemophilus influenzae (especially since vaccination against type b). Because of bacterial sensitivity, PK/PD parameters of antibiotics, and depending on the classification of Chandler, different probabilistic regimens may be proposed: In class 1 by Chandler (preseptal cellulitis), amoxicillinclavulinate (80 mg/kg/d) in 2 oral doses, and ceftriaxone in intramuscular injection; in cases of class 2 to 5 by Chandler, high doses of intravenous amoxicillin-clavulinate (until 150 mg/kg/d of amoxicillin), or intravenous association of ceftriaxone (100 mg/kg/d) or cefotaxim (200 mg/kg/d), with anti-anaerobic like metronidazole (30 mg/kg/d) or clindamycine (40 mg/kg/d).