Peritonsillar infections: management and importance of bacterial culture

ABSTRACT

Peritonstilar infection describes a spectrum of diseases that range from peritonsillar cellulitis to peritonsillar abscess. To assess the disease pattern and its management and to examine the role of routine bacterial cultures. We carried out a prospective study with 30 patients diagnosed with peritonsillar infection. Twenty two patients with peritonsillar abscess [PTA] and eight cases with peritonsillar cellulitis [PTC] of these eight cases 4 cases resolved with medicine and the other 4 cases progressed to [PTA] so finally we have 26 cases with [PTA], for these needle aspiration is done from the most prominent point and if pus came we progressed to incision and drainage wider local or general anesthesia according to patients condition. Around 3ml of pus is taken and sent to lab. Immediately and processed for culture for aerobic and anaerobic organisms. Then these 26 cases of PTA divided into 2 groups each one contains 13 cases group I received ampicillin plus metronidazole and group 2 received 3rd generation cephalosporins plus metronidazole. We assessed number of bacteria per aspirate as well as type of bacteria present aerobic or anaerobic. After results of c/s came we assessed the need to change antibiotics. Lastly we assessed length of stay in the hospital for both groups according to antibiotics used. We found 2.1 bacteria per aspirate. Bacteria grown from all aspirates with culture positivness 100%. We found 55 bacteria grown from 26 cases of PTA, with 28 aerobes and 27 anaerobic organisms. There were need to change antibiotics in 3 cases of group I and in 5 cases of group 2 with significant difference. Mean length of stay in group 1 was 4 +/- 3 while in group 2 was 5 +/- 2 with non significant differences between both groups. 1-Culture and sensitivity of pus drained from PTA should be done. 2-We should use drugs for anaerobic organisms on treatment of peritonsillar infections