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Antibiotic therapy for pediatric deep neck abscesses: a systematic review
Peter N Carbone1, Gregory G Capra, Matthew T Brigger
1Naval Medical Center San Diego, Department of Anatomic Pathology, San Diego, CA 92134, United States.
International Journal of Pediatric Otorhinolaryngology
|August 28, 2012
Summary
Medical management of deep neck abscesses in children shows promise as a safe alternative to surgery. Further research is needed due to limited evidence strength.
Area of Science:
- Pediatric Infectious Diseases
- Otolaryngology
- Evidence-Based Medicine
Background:
- Deep neck abscesses in children often require surgical intervention.
- The role of medical management as an alternative is not fully established.
Purpose of the Study:
- To systematically review the existing literature on the safety and efficacy of non-surgical treatment for pediatric deep neck abscesses.
- To evaluate the success rates of medical therapy in managing these infections.
Main Methods:
- A comprehensive search of the PubMed and Embase databases was conducted.
- Inclusion criteria focused on studies detailing diagnostic criteria, medical therapy specifics, and failure definitions.
- Data were extracted and pooled using a random effects model due to significant heterogeneity.
Main Results:
- Eight articles met the inclusion criteria, with an overall level of evidence rated as Grade C.
- Medical therapy demonstrated a pooled success rate of 51.7% in avoiding surgery.
- Success rates increased to 95.1% when immediate surgical cases were excluded and to 74.0% for trials longer than 48 hours.
Conclusions:
- Current evidence suggests medical management may be a safe alternative to surgical drainage for pediatric deep neck abscesses.
- The strength of the evidence is limited, highlighting the need for further high-quality investigations.
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