Do corticosteroids improve outcomes in peritonsillar abscess?

Hardman, John; McCulloch, N.A.; Nankivell, Paul

doi:10.1002/lary.24936

Cited by 7 publications

(11 citation statements)

References 5 publications

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“…We obtained full‐text articles for six titles in our review. Two of the articles were excluded because they did not meet the criteria of an RCT . One article was excluded for not evaluating steroid treatment after PTA drainage or aspiration …”

Section: Resultsmentioning

confidence: 99%

“…The efficacy of adjuvant corticosteroid use following acute procedural treatment is controversial due to concerns regarding possible side effects. 15 Recurrence of PTA or progression to deep-space neck infections have been discussed as a possible long-term complication of adjunct steroid administration. 11,15 However, in this review, no side effects from steroid administration were reported in the three RCTs.…”

Section: Discussionmentioning

confidence: 99%

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Adjunct steroids in the treatment of peritonsillar abscess: A systematic review

2017

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Adjunct steroids in the treatment of peritonsillar abscess: A systematic review

2017

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“…[21][22][23] Corticosteroids are conventionally used in more severe cases and in those with suspected peritonsillar abscess, primarily for symptomatic relief. [11][12][13]24 The unwanted effects of corticosteroids on immunity, in the context of uncertain viral exposure in the community, were considered with caution early on in the pandemic. 11,25,26 However, widespread use of steroids in these cases appears to have continued during the pandemic, as reported in the 'Integrate' (the UK ENT Research Trainee Network) Covid-19 ENT emergency care audit.…”

Section: Discussionmentioning

confidence: 99%

Improving the management of suspected tonsillitis and peritonsillar abscess referred to ENT – a coronavirus disease 2019 service improvement

et al. 2021

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Background. The impact of coronavirus disease 2019 on healthcare has led to rapid changes in otolaryngology service provisions. As such, new standard operating procedures for the management of suspected tonsillitis or quinsy were implemented in our centre. Methods.A retrospective audit was performed of acute referrals to ENT of patients with suspected tonsillitis, peritonsillar cellulitis or quinsy, during the 10 weeks before (group 1) and 10 weeks after (group 2) implementation of the new standard operating procedures.Results. Group 2 received fewer referrals. Fewer nasendoscopies were performed and corticosteroid use was reduced. The frequency of quinsy drainage performed under local anaesthetic increased, although the difference was not statistically significant. Hospital admission rates decreased from 56.1 to 20.4 per cent,

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“…In randomized, prospective trials, dexamethasone has been shown to significantly lower pain and improve trismus, dysphagia, body temperature, and hours of hospitalization. 12-14…”

Section: Discussionmentioning

confidence: 99%

Comparison of Medical Therapy Alone to Medical Therapy with Surgical Treatment of Peritonsillar Abscess

Battaglia¹,

Burchette²,

Hussman

et al. 2017

Otolaryngol.--head neck surg.

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Objective This study was performed to determine whether the efficacy and safety of medical management of uncomplicated peritonsillar abscess (PTA) presenting in the emergency department is equivalent to medical plus surgical therapy. Study Design Case series with chart review. Setting Southern California Permanente Medical Group (SCPMG). Subjects and Methods Upon successful completion of a prospective study comparing medical treatment (MT) to surgical treatment (ST) of PTA in 2008, MT was adopted by 12 SCPMG centers while 7 centers continued standard surgical drainage. Clinical outcomes are now reviewed on a random sampling of 211 patients with PTA treated with MT and 96 patients treated with ST between 2008 and 2013 at the respective medical centers. Patients were treated with intravenous (IV) fluids, weight-appropriate IV ceftriaxone, clindamycin, and dexamethasone, and then discharged on clindamycin × 10 days (MT). Patients in the ST group received MT but also surgical drainage. Primary end points were complication rates and failure rates. Results MT and ST resulted in no significant difference in treatment success or complications. However, patients in the MT group obtained significantly less liquid opioid prescriptions (MT, 30.8 ± 5.65; ST, 77.75 ± 13.41; P < .0001), reported fewer sore days (MT, 4.48 ± 0.27; ST, 5.77 ± 0.49; P = .0004), and required less days off from work (MT, 3.4 ± 0.44; ST, 4.9 ± 0.82; P = .044). Conclusions Compared to ST, MT appears to be equally safe and efficacious, with less pain, opioid use, and days off work, especially if patients with PTA present without trismus. MT for PTAs reduces the possibility of surgical complications, as well as the cost and inconvenience associated with ST.

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Do corticosteroids improve outcomes in peritonsillar abscess?

Cited by 7 publications

References 5 publications

Adjunct steroids in the treatment of peritonsillar abscess: A systematic review

Adjunct steroids in the treatment of peritonsillar abscess: A systematic review

Improving the management of suspected tonsillitis and peritonsillar abscess referred to ENT – a coronavirus disease 2019 service improvement

Comparison of Medical Therapy Alone to Medical Therapy with Surgical Treatment of Peritonsillar Abscess

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