2015 Volume 108 Issue 6 Pages 465-470
We treated 62 cases of peritonsillar abscess between January 2011 and July 2014. The patients were classified into 2 groups according to whether the abscesses was located in the superior pole (superior pole group; 50 cases) or the inferior pole (inferior pole group; 12 cases). There were significant differences between the inferior pole group and superior pole group in the age of onset (52.6±6.6 vs. 39.5±2.6, P=0.04), leukocyte count (15900±1600/μl vs. 12800±5600/μl, P=0.02), degree of the laryngeal edema (58% vs. 22%, P=0.01), size of the retropharyngeal abscess (8% vs. 0%, P=0.04) and the percentage of patients needing drainage construction (33% vs. 88%, P<0.01).
In addition, all the patients were classified into four groups depending on the type of antimicrobial agents administerd, namely, the “penicillin” group, “penicillin or cephem plus clindamycin (CLDM)” group, “doripenem (DRPM)” group, and the “DRPM plus CLDM” group. We selected DRPM as the carbapenem antibiotic. All of the patients of the inferior pole group who were treated with DRPM with or without CLDM were cured. Three patients of the superior pole group were not cured with a penicillin, with or without CLDM.
The overall efficacy rates in the “penicillin” group, “penicillin or cephem plus CLDM” group, “DRPM” group, and “DRPM plus CLDM” group were 50%, 77%, 86% and 67%, respectively. There were significant differences in the efficacy between the “penicillin” group” and the other groups (P<0.01).
We concluded that a cephem/penicillin plus CLDM should be selected for the treatment of peritonsillar abscesses in the superior pole. For abscesses in the inferior pole, the selection of a carbapnem would be the more desirable for the purpose of preventing exacerbations. However, we need to revise the treatment policy from the viewpoint of proper use of antimicrobials.
