Corticosteroids in pediatric retropharyngeal and parapharyngeal abscesses: a systematic review

By synthesizing and analyzing existing research data, this study evaluates the clinical efficacy and safety of corticosteroids in the treatment of pediatric retropharyngeal abscess (RPA) and parapharyngeal abscess (PPA).

Two authors independently searched PubMed, EMBASE, Cochrane Library, and Web of Science, for studies relating to corticosteroids-assisted antibiotic therapy for pediatric RPA and PPA.

Literature was meticulously screened against predefined inclusion and exclusion criteria, and relevant data were extracted. Meta-analysis and systematic review methodologies were employed to synthesize and analyze existing research comprehensively, evaluating clinical efficacy and safety.

Five studies were included (2 retrospective case series, 3 retrospective cohort studies), involving a total of 2560 subjects. The cohort studies demonstrated robust methodological quality. Meta-analysis results indicated significantly lower surgical drainage rates in the steroid group (OR = 0.28; 95% CI: 0.23-0.34; p < 0.01) and reduced hospitalization duration (OR=-0.14; 95% CI: -0.23 to -0.06; p < 0.01) compared to the non-steroid group. Systematic evaluation revealed lower hospitalization costs in the steroid group. Predominantly, studies favored intravenous dexamethasone (82.76%). No adverse reactions to corticosteroids were reported.

Current evidence suggests a beneficial role for corticosteroids in the treatment of pediatric RPA and PPA, emphasizing their importance in symptom improvement, decreased surgical intervention, shortened hospital stays, and reduced hospital costs. However, caution is warranted regarding potential side effects, particularly with long-term use. Future research should further elucidate specific dosages, durations, and optimal types of glucocorticoid therapy to better guide clinical practice.