12/7/2016

Selectionofantibioticsafterincisionanddrainageofperitonsillarabscesses.PubMedNCBI

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OtolaryngolHeadNeckSurg.1999Jan120(1):5761.

Selectionofantibioticsafterincisionanddrainageofperitonsillar
abscesses.
KieffDA1,BhattacharyyaN,SiegelNS,SalmanSD.

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Abstract
Despitethefactthatperitonsillarabscessisthemostcommoncomplicationofacutetonsillitis,the
treatmentofperitonsillarabscessremainscontroversial.Oneelementofcontroversyisthechoiceof
antibioticsafterdrainageoftheabscess.Inanattempttoassesstheeffectofantibioticchoiceonthe
treatmentofperitonsillarabscess,weconductedaretrospectivereviewofrecordsfrompatientswith
peritonsillarabscesstreatedwithincisionanddrainage.Ourreviewidentified103patients,
comprisingtwogroups:58patientstreatedwithbroadspectrumintravenousantibioticsand45
patientstreatedwithintravenouspenicillinalone.Thesepatientswerehospitalizedafterincisionand
drainage,andthereforetheirclinicalcoursesandresponsestotherapycouldberigorously
assessed.Characterizationofillnessbasedonpatientage,temperature,andwhitebloodcellcount
revealedsimilarseverityofillnessbetweenthetwogroups.Comparisonofclinicaloutcomeswith
respecttohourshospitalized(mean44.3+/6.6and38.3+/7.1hours,95%confidenceinterval,for
broadspectrumandpenicillingroups,respectively)andmeanhoursfebrile(16.9+/5.0and13.3+/
4.2hours,95%confidenceinterval)werenotstatisticallysignificantlydifferent(p=0.222and0.269,
respectively)betweengroups,indicatingthatbroadspectrumantibioticsfailedtoshowgreater
efficacythanpenicillininthetreatmentofthesepatients.Themicrobiologiccharacteristicsofthese
infections,failuresoftherapy,andcomplicationratesweresimilartothosereportedintheliterature.
Theseresultssuggestthatintravenouspenicillinremainsanexcellentchoicefortherapyincasesof
peritonsillarabscessrequiringparenteralantibioticsafterdrainage.
PMID:9914550
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