Original article
Study of Cases of Peritonsillar Abscess in the Tokyo Nishitama Area
2017 Volume 120 Issue 6 Pages 817-824
Details
2017 Volume 120 Issue 6 Pages 817-824
Background: Peritonsillar abscess (PTA) may cause severe complications, therefore, prompt and appropriate treatment are crucial.
Objective: 1) To identify the causative pathogenic bacteria and drug resistant variants in cases of PTA in the Tokyo Nishitama area. 2) To study the relationship between the frequency of progression of tonsillitis to PTA after treatment and the prescribed antibiotic treatment.
Subjects and Methods: At first, a total of 214 PTA patients who visited our hospital from April 2010 to March 2016 were enrolled, and we obtained the data on the antibacterial drugs used in these cases. Then, 119 PTA patients seen from April 2010 to March 2014 were included, and we obtained the data on the pathogenic bacteria isolated from the pus and blood cultures and the prevalence of drug resistance from the medical records. Finally, we performed a retrospective cohort study of 397 cases of tonsillitis treated from April 2010 to March 2016 to compare the frequency of development of PTA in patients who had/had not received fluoroquinolones. Furthermore, we performed a subgroup analysis for patients with a past history of tonsillitis or PTA.
Results: Prescriptions from previous hospitals for PTA included cephalosporins in 37% (31/84 prescriptions) of cases and fluoroquinolones in 25% (21/84 prescriptions) of cases. Streptococcus species such as group A β-hemolytic streptococci and anaerobic bacteria accounted for 67% (98/66 strains) and 13%(13/98 strains) of the bacteria isolated from the pus cultures in the PTA cases. The proportion of bacteria that were resistant to fluoroquinolones was as high as 45%. The frequency of development of PTA was significantly higher (risk ratio=11.8, p= 0.032) in the tonsillitis patients who had been treated with fluoroquinolones. Subanalysis of cases with a history of tonsillitis or PTA showed the same results.
Conclusions: Our findings suggest that caution should be exercised in administering fluoroquinolones to patients with tonsillitis with a past history of tonsillitis or PTA. Further study is needed in the future.
