Acute tonsillitis in adults: the bacteriological profile and antibiotic sensitivity pattern in Ajman, UAE

ABSTRACT

The objective of this study was to determine the prevalence, pattern and antibiotic sensitivity of acute tonsillitis. A descriptive study was carried out from January 2011 to December 2011 among all adult patients attending the ENT outpatient department with acute tonsillitis. The data were retrieved from the medical records using a questionnaire. Statistical analysis was carried out using SPSS. 19 version. A total of 175 patients were included. The age ranged from 18 to 70 years. The majority of the patients were Indian 49[20.6%], Emirati 35[14.7%], and Pakistani 31 [13%]. The common clinical types of tonsillitis noted were acute parenchymatous / follicular/ exudative tonsillitis and acute pharyngotonsillitis. The highest frequency of acute tonsillitis was observed in 20- 29 year age group with the commonest symptoms at presentation being sore throat and fever. The tonsils on examination were enlarged in more than half the patients and follicles seen on the congested surface of both or one tonsil in a majority of the patients included in the study. The relative frequency of presentation was high in the summer months from March to September. About one fourth of the study group reported to have had an episode of similar clinical presentation during the previous year. Among the study participants whose throat swab cultures were done, Streptococcus was the commonest species identified, a majority being alpha haemolytic streptococci, followed by streptococcus pyogenes and streptococcus pneumoniae. Most of these organisms were sensitive to third or fourth generation. Cephalosporins and Co-Amoxyclavulanic acid. The majority of patients responded to treatment with oral or parenteral antibiotics of the above group. Some organisms were multi-drug resistant, being sensitive only to piperacillin, ceftriaxone, cefotaxime and meropenem. Therapeutic guidelines for optimum clinical response to acute tonsillitis among adult patients can be developed based on the common organisms grown on throat swab and their antibiotic sensitivity pattern to reduce patient morbidity and provide cost effective treatment