Management of peritonsillar abscess

Abstract

A prospective, randomized clinical trial was conducted on 60 patients with confirmed peritonsillar abscess to: (1) compare the safety and efficacy of permucosal needle aspiration with that of incision and drainage; (2) assess whether admission to hospital and treatment with intravenous antibiotics is necessary; (3) culture the pus obtained, in order to decide on a rational antibiotic regime.Of the 60 patients, 30 were randomized to the needle aspiration group, and 30 to the incision and drainage group. The initial success rate was 87 per cent (26 of 30 patients) with needle aspiration, and 90 per cent (27 of 30 patients) with incision and drainage. Two patients required hospital admission, for rehydration and intravenous antibiotics. The commonest organisms cultured were streptococci (62 per cent); 97 per cent of all patients responded to penicillin. This study indicates that most patients with peritonsillar abscess may successfully and safely be treated by permucosal needle aspiration, and oral penicillin, on an outpatient basis.

The epidemiology of peritonsillar abscess disease in Northern Ireland

“…Beta haemolytic streptococci were the most commonly recovered pathogens; occurring as the sole isolate in 19 (59%) cultures in this study. Again, this is similar to the findings of Hall, Snow et al, and Maharaj et al 6,7,12 However, in those studies in which a diligent search for anaerobes was performed, most cultures were mixed and anaerobes were present in up to 75% of instances. However, beta haemolytic streptococci were still found occasionally in pure culture.…”

“…This is similar to the findings of other studies which were performed using routine hospital processing of specimens. 6,7,12 Needle aspiration of pus from a peritonsillar abscess most frequently yielded a positive culture result, suggesting that this may be the preferred method of specimen collection. This agrees with a study by Hallander et al 13 Throat swabs did not reveal a positive culture in this study except in one patient and this conflicted with a result obtained from culture of the pus.…”

Peritonsillar abscess — Do we need anaerobic cover?

“…A study reported from South Africa has shown a very low yield of 18.3 % [9]. In our study the most predominant anaerobe was Peptostreptococcus seen in 4(18.18%) cases.…”

Absceso y flegmón periamigdalino ¿Lo estamos haciendo bien?

“…La muestra analizada constituyó un número adecuado, superior a algunos reportes 2,11,12 . Sin embargo, el registro de datos incompletos en las fichas clínicas no permitió un análisis de todos los parámetros planificados.…”