The epidemiology of peritonsillar abscess disease in Northern Ireland
Abstract number: 1134_03_116
Hanna B., McMullan R., Gallagher G., Hedderwick S.
1. To describe the epidemiology of peritonsillar abscess disease in Northern Ireland.
2. To investigate the impact of the nature of microbiological sampling on culture results.
3. To describe the impact of culture and sensitivity results on individual patient treatment and for guiding empirical antibiotic therapy.
Retrospective review of cases of peritonsillar abscess identified by diagnostic coding in three centres in Northern Ireland between August 2001 and July 2002.
128 patients with confirmed peritonsillar abscess were treated as inpatients accounting for 1 in 10,000 per year of the population in the hospitals catchment area. The mean age was 26.4 years (range 978). Sixty-nine (54%) patients were male; the mean length of hospital stay was 3 days. Needle aspirates, swabs of pus, throat swabs and blood were submitted for microbial culture. Culture yield was greatest from needle aspirates, and was similar even with prior antibiotic exposure, although the relative frequency of pathogens was different in the group who had received prior antibiotics. Beta-haemolytic streptococci were the most common isolates, however a variety of pathogens were implicated. Throat swabs and blood cultures were typically unhelpful. The results of culture and sensitivity did not affect individual patient treatment, but reviewing the sensitivities demonstrated frequent resistance of isolates of Group A beta-haemolytic streptococci to macrolide antibiotics. Heterophil antibody testing was routine and revealed that EpsteinBarr Virus infectious mononucleosis had a prevalence of 1.8% in this population.
We support the view that aspirates of pus from peritonsillar abscesses should be periodically cultured to guide empirical antibiotic management since performing cultures in every case may be unnecessary. Patients who have taken antibiotics prior to aspiration may be included in such surveillance.
|Session name:||XXIst ISTH Congress|
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