Peritonsillar infection describes a spectrum of diseases that range from peritonsillar cellulitis
to peritonsillar abscess.
Aim of this study :
To assess the disease pattern and its management and to examine the role of routine
bacterial cultures.
Patients and methods:
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
under 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 1
received ampicillin plus metronidazole and group 2 received 3
rd
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 both groups according to antibiotic used.
Results : 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 1 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.
Conclusions : 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 |
