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Risk Factors for Recurrence of Peritonsillar Abscess
Kayoko Mizuno1,2, Masato Takeuchi1, Yo Kishimoto2
1Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
The Laryngoscope
|September 2, 2022
Summary
Adults diagnosed with peritonsillar abscess (PTA) have a higher recurrence risk if they have a history of recurrent tonsillitis or receive less than three days of IV antibiotics. Older age and longer antibiotic treatment may lower PTA recurrence risk.
Area of Science:
- Otolaryngology
- Infectious Diseases
Background:
- Peritonsillar abscess (PTA) is a common complication of tonsillitis.
- Understanding risk factors for PTA recurrence is crucial for effective patient management and treatment strategies.
Purpose of the Study:
- To identify and analyze the risk factors associated with the recurrence of peritonsillar abscess in adult patients.
- To inform clinical decision-making regarding the prevention and treatment of recurrent PTA.
Main Methods:
- Retrospective cohort study utilizing a nationwide Japanese insurance claims database.
- Included adult patients (≥20 years) diagnosed with their first PTA and treated with intravenous antibiotics or surgery within 5 days.
- Multivariable Cox proportional modeling was employed to assess risk factors including age, sex, comorbidities, tobacco use, history of recurrent tonsillitis, antibiotic duration, and surgical intervention.
Main Results:
- A total of 12,012 patients were analyzed, with 11.3% experiencing PTA recurrence.
- Age 40 years or older (aHR: 0.69) and receiving ≥3 days of intravenous antibiotics (aHR: 0.85) were associated with a lower risk of recurrence.
- A history of recurrent tonsillitis significantly increased the risk of PTA recurrence (aHR: 1.79).
Conclusions:
- Factors such as younger age (20-39 years), a history of recurrent tonsillitis, and less than 3 days of intravenous antibiotic therapy may indicate a higher risk for PTA recurrence in adults.
- Further research with detailed clinical data is warranted to validate these findings and refine risk stratification for PTA recurrence.
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