1887

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Volume 71, Issue 9

Peritonsillar abscess: an 8-year retrospective, culture based evaluation of 208 cases No Access

Abstract

Peritonsillar abscess (PTA) is a common infection which requires surgical intervention and suitable antibiotic therapy.

Beside and several other mostly anaerobic bacteria can be cultured from the properly taken pus samples of PTA, the clinical significance of which is still not fully understood.

This study focused on the culture-based microbiological evaluation of PTA cases, compared to surgical intervention and empirical antibiotic management.

A retrospective analysis of PTA cases was performed between 2012 and 2019. Data about the aerobic and anaerobic culture results of the samples taken during different surgical interventions were summarized and the coverage of the empirically selected antibiotics was evaluated. The patient’s history, the development of complications and the recurrence rate were also evaluated.

The microbiological culture results were available for 208 of 320 patients with clinically diagnosed PTA. Incision and drainage (I and D) and immediate tonsillectomy were the leading surgical interventions. Ninety-five species (including 44 ), 52 species and 47 were obtained from PTA samples alone or together with polymicrobial flora. (33.7 %, =28) and (22.9 %, =19) were the dominating pathogens in the 83 monobacterial PTA samples. In >60 % of the patients polymicrobial infection was demonstrated, involving a great variety of anaerobic bacteria. In 22 out of 42 cases where intravenous cefuroxime was empirically started, the therapy should be changed to properly cover the culture-proven anaerobic flora. There were no serious complications, abscess recurrence was detected in two cases (0.96 %).

PTAs are often polymicrobial infections including a great variety of anaerobes. Targeted antibiotic therapy, in conjunction with adequate surgical drainage eliminating the anaerobic milieu, can accelerate the healing process and radically reduce the complication and recurrence rate.

  • Received:
  • Accepted:
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Keyword(s): Actinomyces spp , aerobe , anaerobe , Fusobacterium necrophorum , peritonsillar abscess and Streptococcus pyogenes
© 2022 The Authors
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2022-09-14
2024-04-29
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Peritonsillar abscess: an 8-year retrospective, culture based evaluation of 208 cases
J. Med. Microbiol. 71, 001576 (2022); https://doi.org/10.1099/jmm.0.001576
/content/journal/jmm/10.1099/jmm.0.001576
/content/journal/jmm/10.1099/jmm.0.001576
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