An overview of the microbiology of acute ear, nose and throat infections requiring hospitalisation

Rusan, Maria; Klug, Tejs Ehlers; Ovesen, Therese

doi:10.1007/s10096-008-0619-y

Cited by 44 publications

(53 citation statements)

References 47 publications

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“…Peritonsillar abscess (PTA), the most common complication of tonsillitis, is the most frequent otorhinolaryngological infection that requires hospitalization, with an incidence of 37/100,000 [1,2]. No clinical practice guidelines for the treatment of PTA exist, and, therefore, PTA treatment varies widely among countries, even inside one country in different hospitals [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Who ends up having tonsillectomy after peritonsillar infection?

Wikstén

Hytönen

Pitkäranta

et al. 2011

Eur Arch Otorhinolaryngol

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We wanted to explore how many patients will undergo tonsillectomy during the first 5 years after peritonsillar abscess or peritonsillar cellulitis, and why. In addition we sought predictive factors as to who would benefit from tonsillectomy. Medical records of 809 patients with peritonsillar infection (ICD-10 J36) aged over six were analyzed, and data on the history of tonsil infections and differences in treatment were collected. Data on patients who underwent tonsillectomy during the next 5 years were compared with data on patients needing no tonsillectomy. An abscess or planned interval tonsillectomy was performed on 159 patients. Of the conservatively treated 7- to 16.9-year-old patients, 42.5% required surgery later, of those aged 17-29.9 years, 31.3%, and those over 30, 13.2% (p < 0.001). Previous tonsillar infections led to increased (p = 0.067) probability of delayed tonsillectomy. Re-opening of the abscess cavity at the polyclinics, use of broad-spectrum antibiotics in the acute phase of infection, or being an outpatient or inpatient had no influence on the probability of later surgery. Overall one-fourth of the patients with peritonsillar infection underwent tonsillectomy during the next 5 years, even without being originally planned. Young age and previous tonsillar infections caused increased probability of delayed tonsillectomy.

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Section: Introductionmentioning

confidence: 99%

Who ends up having tonsillectomy after peritonsillar infection?

Wikstén

Hytönen

Pitkäranta

et al. 2011

Eur Arch Otorhinolaryngol

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“…It is the most frequent complication of acute tonsillitis (AT) and the prevailing cause of acute admission to the ENT-department at Aarhus University Hospital [1].…”

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confidence: 99%

Significant pathogens in peritonsillar abscesses

Klug

Henriksen

Fuursted

et al. 2010

Eur J Clin Microbiol Infect Dis

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Purpose: Peritonsillar abscesses (PTA) are polymicrobial infections, with a diverse aerobic and anaerobic flora. The aim of the present study is to compare bacteriologic culture results from patients with PTA to those from patients undergoing elective tonsillectomy (clinically non-infected tonsils), to better elucidate the pathogenic significance of various isolates. Methods: A prospective study was conducted on 36 PTA patients undergoing acute tonsillectomy and on 80 electively tonsillectomized patients. Results: Fusobacterium necrophorum (FN) and Streptococcus Group A (GAS) were isolated significantly more frequently from the tonsillar cores of PTA patients, both from the abscessed (P=0.001 and P=0.046, respectively) and non-abscessed side (P<0.001 and P=0.046, respectively), than from the tonsillar cores of electively tonsillectomized patients. Conclusions:Our findings indicate that FN and GAS are the prominent pathogens in PTA. In patients with PTA the incidence of FN and GAS isolated from the abscessed tonsil was the same as from the non-abscessed contralateral side, and the growth was comparable by a semi-quantitative approach. Our findings suggest that FN is also of pathogenic importance in acute tonsillitis, and that FN growth is not a subsequent phenomenon once an abscess has formed. Our findings further suggest that other factors influence the development of PTA.

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“…A small proportion of children with sore throat develop otitis media, peritonsillar abscess or cellulitis following their bacterial sore throat. These infections can be severe, may require hospitalization and might be prevented by early administration of antibiotics (10). A small proportion of children with GABHS develop serious and potentially life-threatening sequelae such as rheumatic fever or glomerulonephritis or, for adolescents with F. necrophorum infections, Lemierre syndrome (11)(12)(13)(14).…”

Section: How the Interventions Might Workmentioning

confidence: 99%

The Cochrane Library and the Treatment of Sore Throat in Children and Adolescents: An Overview of Reviews

Foisy

Martin

Domino

et al. 2011

Evid.‐Based Child Health

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Background: Sore throat is a common respiratory tract symptom responsible for 6% of children's visits to pediatricians or family physicians. Even though sore throat is usually self-limiting, antibiotics are often prescribed in hopes of decreasing symptom length and the risk of developing sequelae. However, antibiotic overprescription could lead to adverse events in individuals and bacterial resistance in the community, so the efficacy and safety of antibiotics must first be established, and alternative treatment options should also be investigated.Objectives: This overview of reviews aims to synthesize evidence from the Cochrane Database of Systematic Reviews (CDSR) on the efficacy and safety of different antibiotic treatment strategies (standard antibiotics, delayed antibiotics, short-duration antibiotics and different types of antibiotics) to improve symptoms of sore throat in children and adolescents. The efficacy and safety of two other treatments, steroids and Chinese herbal medicine, are also investigated.Methods: Issue 1, 2011 of the CDSR was searched for all reviews examining the treatment of sore throat and disorders which commonly have sore throat as part of their clinical presentation. We also searched for reviews examining the prevention of important sequelae of sore throat. All systematic reviews examining pharmacologic or non-pharmacologic treatments in children were identified, and data were extracted, compiled into tables and synthesized using quantitative and qualitative methods.Main results: Data pertaining to sore throat in children and adolescents were extracted from seven Cochrane reviews. Antibiotics provided only modest benefit over placebo for symptoms of sore throat and fever. Immediate versus delayed prescription of antibiotics resulted in a 58% decrease in severity of pain due to sore throat on day three (RR: 0.42; 95% CI: 0.33, 0.54), and a significant, moderate decrease in fever on day three (SMD: −0.53; 95% CI: −0.74, −0.31). Most studies of macrolides, cephalosporins and carbacephem showed no significant benefit over oral penicillin for resolution of symptoms, but in two trials a short course of a cephalosporin compared to oral penicillin led to modest decreases in both sore throat (half a day; MD: −0.50; 95% CI: −0.78, −0.22) and fever (seven hours; MD: −0.30; 95% CI: −0.45, −0.14). Steroids compared to placebo decreased symptoms of sore throat in children with infectious mononucleosis at 12 hours (RR: 0.54; 95% CI: 0.30, 0.99) but not at any other measured time points. A higher rate of vomiting was associated with delayed antibiotics (RR: 0.07; 95% CI: 0.03, 0.20); vomiting, diarrhea and abdominal pain were associated with short-duration antibiotics (RR: 1.74; 95% CI: 1.31, 2.32); and overall adverse effects were associated with macrolides (RR: 2.19; 95% CI: 1.04, 4.61). Trials involving Chinese herbal medications for sore throat were of low quality and no good evidence for the use of these agents was available. Antibiotics compared to placebo were associated with lower rates of a...

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An overview of the microbiology of acute ear, nose and throat infections requiring hospitalisation

Cited by 44 publications

References 47 publications

Who ends up having tonsillectomy after peritonsillar infection?

Who ends up having tonsillectomy after peritonsillar infection?

Significant pathogens in peritonsillar abscesses

The Cochrane Library and the Treatment of Sore Throat in Children and Adolescents: An Overview of Reviews

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