Success in changing from intravenous to oral antibiotics in pediatric intracranial infections: report of three cases

Introduction: Acute bacterial rhinosinusitis is a common infection in children. Intracranial complications like subdural empyema or brain abscess are rare, albeit with significant morbidity and neurological sequelae. Case report: We present three clinical cases of intracranial suppurative complications secondary to sinus infection in which the transition to oral antibiotic therapy took place between day 14 and day 21 of intravenous treatment. In all, both neurosurgery and otorhinolaryngology surgery with empyema and sinus drainage were performed, the bacterial etiology was identified and clinical cure was achieved with no relapses. Discussion: Although the early transition to oral antimicrobials has been adopted in some countries, effectiveness and safety remain uncertain. The optimal timing for the transition to oral antibiotic therapy is not well established, but an early switch to oral treatment has been suggested to be equally effective and safe.