Is postoperative antibiotic treatment mandatory after abscess tonsillectomy

Knipping, S.; Löwe, S.; Lautenschlãger, C.; Schrom, T.

doi:10.1007/s00106-008-1777-z

Cited by 10 publications

(1 citation statement)

References 23 publications

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“…It is possible that the simple act of draining the abscess is effective treatment and that antibiotic therapy may not be necessary. A German study investigated this prospectively in abscesses treated with tonsillectomy and found no difference between the treatment and control groups [8]. Generalizing these findings to needle drainage is likely not valid, but does provide further evidence that definitive drainage of the abscess may well be sufficient.…”

Section: Discussionmentioning

confidence: 99%

The epidemiology, antibiotic resistance and post-discharge course of peritonsillar abscesses in London, Ontario

Sowerby

Hussain

Husein

2013

Journal of Otolaryngology - Head & Neck Surgery

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BackgroundPeritonsillar abscesses (PTA) are a common complication of tonsillitis. Recent global epidemiological data regarding PTAs have demonstrated increasing antimicrobial resistance patterns. No similar studies have been conducted in Canada and no Canadian study has examined the post-discharge course of treated patients.MethodsA prospective observational study of the epidemiology, antibiotic resistance and post-discharge course of patients presenting with a peritonsillar abscess to the Emergency Department in London, Ontario over one year. A follow-up telephone survey was conducted 2–3 weeks after abscess drainage.Results60 patients were diagnosed with an abscess, giving an incidence of 12/100,000. 46 patients were enrolled in the study; the average duration of symptoms prior to presentation was 6 days, with 51% treated with antibiotics prior to presentation. Streptococcus pyogenes and Streptococcus anginosus were present in 56% of isolates and of those, 7/23 (32%) of specimens demonstrated resistance to clindamycin. Eight patients were treated with clindamycin and had a culture that was resistant, yet only one had recurrence. Telephone follow-up was possible for 38 patients: 51% of patients reported a return to solid food within 2 days, and 75% reported no pain by 5 days. Resolution of trismus took a week or longer for 51%.InterpretationClindamycin resistance was identified in a third of Streptococcus isolates, which should be taken into account when prescribing antibiotics. Routine culture appears unnecessary as patients recover quickly from outpatient drainage and empiric therapy, with less pain than expected, but trismus takes time to resolve.

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Section: Discussionmentioning

confidence: 99%