Related Experiment Videos
The microbiology and antibiotic treatment of peritonsillar abscesses
A Prior1, P Montgomery, I Mitchelmore
1Department of Otolaryngology, St Bartholomew's Hospital, London, UK.
Abstract:
Pus from 53 peritonsillar abscesses was cultured and associations between the microbiological results and clinical data were investigated with the aim of developing a clinical protocol for treatment. A positive culture grew in 85% of quinsies and of these 16% produced aerobes and 84% anaerobes. Penicillin-resistant organisms were grown from 32% of patients and all but one of these organisms (Haemophilus influenzae) was sensitive to metronidazole. There was no association between clinical presentation and cultured organism which could guide treatment, hence we recommend penicillin and metronidazole as the antibiotic regimen of choice in the treatment of peritonsillar abscesses because of its effectiveness in 98% of patients.
Insights
Peritonsillar abscess treatment can be guided by antibiotics. Penicillin and metronidazole are effective in 98% of cases, including those with penicillin-resistant organisms.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Microbiology
Background:
- Peritonsillar abscess (quinsy) is a common complication of tonsillitis.
- Microbiological analysis of abscess pus is crucial for effective treatment protocols.
Purpose of the Study:
- To investigate the microbiological profile of peritonsillar abscesses.
- To correlate microbiological findings with clinical data to inform treatment strategies.
- To establish an optimal antibiotic regimen for peritonsillar abscesses.
Main Methods:
- Pus samples from 53 peritonsillar abscesses were cultured.
- Microbiological results were analyzed alongside clinical data.
- Antibiotic sensitivity testing was performed for isolated organisms.
Main Results:
- 85% of abscesses yielded positive cultures, predominantly anaerobes (84%).
- Penicillin-resistant organisms were identified in 32% of patients.
- Metronidazole demonstrated high sensitivity against penicillin-resistant isolates, except for one instance of Haemophilus influenzae.
- No clear association was found between clinical presentation and specific cultured organisms.
Conclusions:
- Clinical presentation does not reliably predict causative organisms in peritonsillar abscesses.
- A combination of penicillin and metronidazole is recommended as the empirical antibiotic treatment.
- This regimen demonstrated high effectiveness (98%) in the studied patient cohort.