Dexamethasone for Orbital Cellulitis

(VISION Pilot Trial)

Not yet recruiting at 1 trial location
PJ
AS
Overseen ByAnmol Samra, MPH, BSc
Age: < 18
Sex: Any
Trial Phase: Academic
Sponsor: The Hospital for Sick Children

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if dexamethasone, a steroid medication, can effectively treat orbital cellulitis, a serious infection around the eye. It serves as a precursor to a larger study, focusing on enrolling enough participants, administering the treatment correctly, and gathering all necessary information. Participants will receive either dexamethasone or a placebo (an inactive substance) to compare effects. The trial seeks children and teens diagnosed with orbital cellulitis who are scheduled for hospital admission and have been hospitalized for less than 36 hours. As an unphased trial, this study allows participants to contribute to important research that could lead to better treatments for future patients.

Is there any evidence suggesting that dexamethasone is likely to be safe for humans?

Research has shown that using dexamethasone to treat orbital cellulitis appears safe. In children with this condition, adding steroids like dexamethasone may speed recovery and is generally well-tolerated. Although some studies suggest that steroids don't always enhance outcomes, they don't seem to cause harm. This makes dexamethasone a potentially safe option for further exploration in clinical trials.12345

Why are researchers excited about this trial?

Most treatments for orbital cellulitis typically involve antibiotics to tackle the underlying bacterial infection. However, researchers are excited about using dexamethasone because it offers an anti-inflammatory approach that could reduce swelling and pressure in the orbit more rapidly. This corticosteroid works differently from antibiotics by targeting inflammation directly, potentially leading to quicker symptom relief. Additionally, its administration via intravenous injection ensures fast delivery to the affected area, which might enhance its effectiveness in acute situations.

What evidence suggests that dexamethasone might be an effective treatment for orbital cellulitis?

This trial will compare the effects of dexamethasone and a placebo in treating orbital cellulitis. Research has shown that dexamethasone, a type of medicine, might reduce swelling and inflammation in serious eye infections by decreasing inflammation around the eye. However, results from studies are mixed. Some studies have not demonstrated clear benefits for children with eye infections when using steroids like dexamethasone. Evidence also suggests that dexamethasone might improve quality of life and reduce the need for additional treatments in other types of infections. While there is potential, more research is needed to confirm its effectiveness specifically for eye infections.12467

Are You a Good Fit for This Trial?

This trial is for children and youth aged 2 months to under 18 years, hospitalized with confirmed or suspected orbital cellulitis. They must be admitted for less than 36 hours, have not received recent corticosteroids treatment, and cannot have been exposed to varicella or had a recent hospital admission for the same condition.

Inclusion Criteria

I am younger than 18 years old.
Scheduled to be admitted or admitted to hospital for less than 36 hours
Informed consent provided in accordance with institutional policies
See 1 more

Exclusion Criteria

Clinically relevant varicella exposure in the previous 21 days
Previous enrollment in this study
I have a fungal infection in my body.
See 6 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive IV dexamethasone 0.3 mg/kg or placebo, with two doses administered 24 hours apart

1 week
In-hospital treatment

Follow-up

Participants are monitored for safety and effectiveness after treatment, including intervention fidelity and completion of trial outcomes

3 months

What Are the Treatments Tested in This Trial?

Interventions

  • Dexamethasone

Trial Overview

The study compares Dexamethasone (0.3mg/kg) with a placebo in treating orbital cellulitis in young patients. It's a pilot randomized controlled trial aiming to check feasibility for a larger future trial by assessing patient recruitment, intervention administration, and data collection.

How Is the Trial Designed?

2

Treatment groups

Experimental Treatment

Placebo Group

Group I: InterventionExperimental Treatment1 Intervention
Group II: PlaceboPlacebo Group1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

The Hospital for Sick Children

Lead Sponsor

Trials
724
Recruited
6,969,000+

Canadian Institutes of Health Research (CIHR)

Collaborator

Trials
1,417
Recruited
26,550,000+

Citations

Association of systemic corticosteroids and clinical ...

Corticosteroids may improve outcomes in severe orbital infections by reducing inflammation and oedema within the enclosed bony orbit, thereby ...

Association Between Corticosteroids and Outcomes in ...

Early use of systemic corticosteroids in hospitalized children with orbital cellulitis is not associated with improved clinical outcomes. Use ...

Corticosteroids for periorbital and orbital cellulitis

We aimed to find out if steroids are useful in treating serious infections of the area around the eye known as periorbital and orbital cellulitis.

The DEXACELL trial—a protocol for a pragmatic, ...

This trial aims to determine if adjunctive oral dexamethasone can reduce pain and improve outcomes in adults with cellulitis presenting to UK urgent secondary ...

Dexamethasone versus placebo for patients with cellulitis

1. Improves quality of life and other patient-reported outcomes · 2. Reduces subsequent antimicrobial prescribing, analgesia usage and healthcare utilisation · 3.

Adjunct steroid treatment may hasten recovery in pediatric ...

However, this article and other literature do show that steroid use in cases of pediatric orbital cellulitis appears safe and likely reduces ...

7.

pubmed.ncbi.nlm.nih.gov

pubmed.ncbi.nlm.nih.gov/41381246

Association of systemic corticosteroids and clinical ...

Objectives: To evaluate the association between corticosteroid use and clinical outcomes in children hospitalised with severe orbital infections ...