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Peritonsillar infection in Christchurch 2006-2008: epidemiology and microbiology
Rachelle L Love1, Rob Allison, Stephen T Chambers
1ORL Department, Christchurch Public Hospital, Christchurch, New Zealand. rsalter@clear.net.nz
Aim:
Peritonsillar infection is a complication of acute tonsillitis. It is common and complications can be life-threatening. This study audits all cases of peritonsillar infection presenting to our unit between 2006 and 2008 in order to determine if the epidemiology, bacteriology and antibiotic sensitivity has changed since previous audits in our unit in 1981-1984 and 1990-1992.
Methods:
Retrospective chart review.
Results:
213 patients were admitted acutely with peritonsillar infection between January 2006 and December 2008. The average age was 29 years with 30.5% patients in the modal age group of 15-19 years. Male to female ratio was 1.5:1. 54% presented with their first episode. 39% received antibiotics prior to presentation. In two-thirds of cases, the duration of admission was less than 24 hours. Culture results were obtained from 69% of specimens. Cultures mostly contained mixed anaerobic and aerobic bacteria. The most common aerobes were streptococcal species. Organisms were almost uniformly sensitive to penicillin. 21% of patients subsequently underwent tonsillectomy, usually as a delayed procedure.
Conclusion:
Peritonsillar infection is a common complication of tonsillitis and can be life-threatening. The number of cases presenting at Christchurch Hospital has increased disproportionate to the population increase since the previous audits. Culture results demonstrate a preponderance of mixed organisms, which may be pathological. Organisms and their sensitivities have not changed since the previous audits. Infection usually responds favourably to drainage in combination with penicillin as the first-line antimicrobial agent.
Insights
Peritonsillar infections, a complication of acute tonsillitis, are common and can be serious. This study found that the bacteria causing these infections and their sensitivity to antibiotics have not changed since previous audits.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Microbiology
Background:
- Peritonsillar infection is a serious complication of acute tonsillitis.
- Early diagnosis and treatment are crucial to prevent life-threatening complications.
Purpose of the Study:
- To audit cases of peritonsillar infection presenting to Christchurch Hospital between 2006 and 2008.
- To compare current epidemiology, bacteriology, and antibiotic sensitivity with previous audits from 1981-1984 and 1990-1992.
Main Methods:
- Retrospective chart review of patients admitted with peritonsillar infection.
- Analysis of patient demographics, clinical presentation, and treatment outcomes.
- Microbiological culture and sensitivity testing of infection specimens.
Main Results:
- 213 patients were admitted; the average age was 29, with a peak in the 15-19 age group.
- Mixed aerobic and anaerobic bacteria were common, with streptococcal species most frequent among aerobes.
- Organisms remained uniformly sensitive to penicillin, and most infections responded well to drainage and antibiotics.
Conclusions:
- The incidence of peritonsillar infection has increased disproportionately to population growth.
- Bacteriology and antibiotic sensitivities have remained consistent since previous audits.
- Penicillin remains the first-line antimicrobial agent for treating peritonsillar infections, often in conjunction with surgical drainage.
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It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
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