National audit of the management of peritonsillar abscess

Mehanna, Hisham; Al-Bahnasawi, L; White, A. C.

doi:10.1136/pmj.78.923.545

Cited by 66 publications

(54 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…On the opposite, in the US the majority of cases are treated as outpatients [37]. This difference may be due to the differences in set-ups and outpatient support mechanisms of the health services, or may be driven by economic factors [36]. In our study, age-and gender-stratified population data are in agreement with what previously reported in the literature.…”

Section: Discussionsupporting

confidence: 91%

“…Most probably, variations in clinical practice and their effects might greatly depend on regional variations in disease presentation [35]. With regard to the above-reported PTA incidence in Veneto, it is to be noted that the hospital admission criteria have not changed during the considered decade: as recommended by the local guidelines, this condition was always treated on an inpatient basis [29] and this practice is common in the rest of Europe, too [36]. On the opposite, in the US the majority of cases are treated as outpatients [37].…”

Section: Discussionmentioning

confidence: 95%

See 1 more Smart Citation

Hospital discharge survey on 4,199 peritonsillar abscesses in the Veneto region: what is the risk of recurrence and complications without tonsillectomy?

Bovo

Barillari

2015

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

The Veneto region's database of hospital discharge records was queried for ICD-9 codes corresponding to: peritonsillar abscess (PTA), PTA incision and drainage, tonsillectomy, pharyngeal-retropharyngeal abscess, cervical phlegmon, cervical abscess, and mediastinitis recorded from 1997 to 2006. All these codes were considered to identify cases of PTA recurrence and severe infectious complications occurring in conservatively treated patients. Among 4,199 patients whose PTA was incised and drained on admission to hospital, 1,532 were treated with tonsillectomy, while 2,667 were treated conservatively (without tonsillectomy). Abscess tonsillectomy was carried out almost exclusively in children (0-14 years of age), and only in 40 young and adult patients (0.95 %). The relapse rate after a single episode of PTA was 11.7 %, while potentially fatal complication occurred in 0.41 % of cases. Incidence of PTA hospital admission has remained stable in the considered period despite a 45 % reduction in the tonsillectomy rate. In conclusion, our data seem to show that conservative treatment for PTA is not associated with a significant risk of recurrence (and becomes minimal after 6-12 months), provided that patients have not suffered from previous PTA episodes.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 95%

Hospital discharge survey on 4,199 peritonsillar abscesses in the Veneto region: what is the risk of recurrence and complications without tonsillectomy?

Bovo

Barillari

2015

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

show abstract

“…Various options for invasive management include incision and drainage, aspiration with a needle, and tonsillectomy (TE) au chaud. In the UK, most patients are inpatients, but in the USA, most physicians treat them as outpatients [3,4]. Antibiotic administration can be oral, intramuscular, or intravenous.…”

Section: Introductionmentioning

confidence: 99%

Variations in treatment of peritonsillar abscess in four Nordic countries

Wikstén

Blomgren

Eriksson

et al. 2014

Acta Oto-Laryngologica

View full text Add to dashboard Cite

A total of 73 physicians (90%) replied. The largest differences arose in treating patients with intravenous versus per oral antibiotics, and treating as inpatients versus outpatients. In Finland, 50% of PTA patients aged >16 years were treated as inpatients and 50% as outpatients, whereas the respective quotas in Sweden were 9 and 91%, Norway 19 and 81%, and Denmark 33 and 67%. Of Finnish physicians, 30% treated their patients primarily with oral antibiotics, 70% with intravenous antibiotics; in Sweden 91 vs 9%, Norway 53 vs 47%, and Denmark 18 vs 82%. In Denmark, almost all patients were operated on immediately, whereas in the other three countries, especially Sweden, operations more often were performed after a recovery period. Combining metronidazole with penicillin or cephalosporins was most common in Denmark: 58% reported usage, compared with 30% in Finland, 16% in Norway, and 4% in Sweden.

show abstract

“…Peritonsillar abscess (PTA) is a collection of pus between the fibrous capsule of the palatine tonsil and the superior constrictor muscle of the pharynx, arising as a complication of acute tonsillitis or potentially by direct spread from infection of Weber's glands [1,2]. Management requires antimicrobial therapy with or without surgical drainage, and inadequate treatment may lead to serious complications such as airway compromise from epiglottal or laryngeal edema, deep neck abscess of the para-or retropharyngeal spaces, or mediastinitis [3].…”

Section: Introductionmentioning

confidence: 99%