The role of bacteriological studies in the management of peritonsillar abscess

Tomoyasu Tachibana, Yorihisa Orita, Soshi Takao, Yuya Ogawara, Yuko Matsuyama, Aiko Shimizu, Iku Abe-Fujisawa, Michihiro Nakada, Yasuharu Sato, Kazunori Nishizaki

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective Since most patients with peritonsillar abscess (PTA) can be successfully treated with surgical drainage and empirical antibiotic therapy, routine bacteriologic studies for all patients with PTA may be unnecessary. This study tried to evaluate which patients with PTA should certainly undergo bacteriologic studies. Methods Hundred consecutive patients with PTA were treated and underwent culture tests of purulent contents obtained by surgical drainage between April 2008 and December 2013. Results In 62 of the 100 patients, 71 pathogenic bacteria were identified; 61 (86%) were Gram-positive cocci (GPC), 8 (11%) were Gram-negative rods (GNR), and 6 (8%) were anaerobes. Normal flora were isolated in 27 patients, and culture results were negative in 11 patients. Although not significant, primary (without prior antibiotic therapy) case (odds ratio (OR) = 2.19; 95% CI, 0.95–5.05) and laryngeal edema (OR = 2.04; 95% CI, 0.82–5.03) showed a tendency of associations with detection of pathogenic bacteria. After taking into account interactions between smoking habit and laryngeal edema, the covariate-adjusted OR for non-smokers with laryngeal edema was significant and showed a strong relationship (OR = 7.43; 95% confidence interval, 1.05–52.73) compared to non-smokers without laryngeal edema. Conclusion Although empirical antibiotic therapy was effective for most of the PTA patients, bacteriologic studies might be indispensable for the patients with laryngeal edema considering the failure of the first treatments. Particularly, the culture tests may be useful for non-smokers with laryngeal edema.

Original languageEnglish
Pages (from-to)648-653
Number of pages6
JournalAuris Nasus Larynx
Volume43
Issue number6
DOIs
Publication statusPublished - Dec 1 2016

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Peritonsillar Abscess
Laryngeal Edema
Odds Ratio
Anti-Bacterial Agents
Drainage
Bacteria
Gram-Positive Cocci
Treatment Failure
Habits
Therapeutics
Smoking
Confidence Intervals

Keywords

  • Culture test
  • Laryngeal edema
  • Microbiology
  • Peritonsillar abscess
  • Smoker

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

The role of bacteriological studies in the management of peritonsillar abscess. / Tachibana, Tomoyasu; Orita, Yorihisa; Takao, Soshi; Ogawara, Yuya; Matsuyama, Yuko; Shimizu, Aiko; Abe-Fujisawa, Iku; Nakada, Michihiro; Sato, Yasuharu; Nishizaki, Kazunori.

In: Auris Nasus Larynx, Vol. 43, No. 6, 01.12.2016, p. 648-653.

Research output: Contribution to journalArticle

Tachibana, T, Orita, Y, Takao, S, Ogawara, Y, Matsuyama, Y, Shimizu, A, Abe-Fujisawa, I, Nakada, M, Sato, Y & Nishizaki, K 2016, 'The role of bacteriological studies in the management of peritonsillar abscess', Auris Nasus Larynx, vol. 43, no. 6, pp. 648-653. https://doi.org/10.1016/j.anl.2016.01.009
Tachibana, Tomoyasu ; Orita, Yorihisa ; Takao, Soshi ; Ogawara, Yuya ; Matsuyama, Yuko ; Shimizu, Aiko ; Abe-Fujisawa, Iku ; Nakada, Michihiro ; Sato, Yasuharu ; Nishizaki, Kazunori. / The role of bacteriological studies in the management of peritonsillar abscess. In: Auris Nasus Larynx. 2016 ; Vol. 43, No. 6. pp. 648-653.
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AU - Matsuyama, Yuko

AU - Shimizu, Aiko

AU - Abe-Fujisawa, Iku

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AU - Sato, Yasuharu

AU - Nishizaki, Kazunori

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N2 - Objective Since most patients with peritonsillar abscess (PTA) can be successfully treated with surgical drainage and empirical antibiotic therapy, routine bacteriologic studies for all patients with PTA may be unnecessary. This study tried to evaluate which patients with PTA should certainly undergo bacteriologic studies. Methods Hundred consecutive patients with PTA were treated and underwent culture tests of purulent contents obtained by surgical drainage between April 2008 and December 2013. Results In 62 of the 100 patients, 71 pathogenic bacteria were identified; 61 (86%) were Gram-positive cocci (GPC), 8 (11%) were Gram-negative rods (GNR), and 6 (8%) were anaerobes. Normal flora were isolated in 27 patients, and culture results were negative in 11 patients. Although not significant, primary (without prior antibiotic therapy) case (odds ratio (OR) = 2.19; 95% CI, 0.95–5.05) and laryngeal edema (OR = 2.04; 95% CI, 0.82–5.03) showed a tendency of associations with detection of pathogenic bacteria. After taking into account interactions between smoking habit and laryngeal edema, the covariate-adjusted OR for non-smokers with laryngeal edema was significant and showed a strong relationship (OR = 7.43; 95% confidence interval, 1.05–52.73) compared to non-smokers without laryngeal edema. Conclusion Although empirical antibiotic therapy was effective for most of the PTA patients, bacteriologic studies might be indispensable for the patients with laryngeal edema considering the failure of the first treatments. Particularly, the culture tests may be useful for non-smokers with laryngeal edema.

AB - Objective Since most patients with peritonsillar abscess (PTA) can be successfully treated with surgical drainage and empirical antibiotic therapy, routine bacteriologic studies for all patients with PTA may be unnecessary. This study tried to evaluate which patients with PTA should certainly undergo bacteriologic studies. Methods Hundred consecutive patients with PTA were treated and underwent culture tests of purulent contents obtained by surgical drainage between April 2008 and December 2013. Results In 62 of the 100 patients, 71 pathogenic bacteria were identified; 61 (86%) were Gram-positive cocci (GPC), 8 (11%) were Gram-negative rods (GNR), and 6 (8%) were anaerobes. Normal flora were isolated in 27 patients, and culture results were negative in 11 patients. Although not significant, primary (without prior antibiotic therapy) case (odds ratio (OR) = 2.19; 95% CI, 0.95–5.05) and laryngeal edema (OR = 2.04; 95% CI, 0.82–5.03) showed a tendency of associations with detection of pathogenic bacteria. After taking into account interactions between smoking habit and laryngeal edema, the covariate-adjusted OR for non-smokers with laryngeal edema was significant and showed a strong relationship (OR = 7.43; 95% confidence interval, 1.05–52.73) compared to non-smokers without laryngeal edema. Conclusion Although empirical antibiotic therapy was effective for most of the PTA patients, bacteriologic studies might be indispensable for the patients with laryngeal edema considering the failure of the first treatments. Particularly, the culture tests may be useful for non-smokers with laryngeal edema.

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KW - Microbiology

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