2013 Volume 136 Pages 173-181
In a retrospective clinical evaluation of serious bacterial infections, we reviewed 26 cases – 15 males and 11 females from 4 to 76 years old (median: 37.5) – treated with drip infusion of antibiotics without hospitalization at 7 months from January to July, 2007. The indications for drip infusion of antibiotics were acute tonsillitis in 9 cases, peritonsillitis in 6 cases including 2 cases with abscess formation, lymphadenitis of the neck in 3 cases, acute epiglottitis (stage I and III), laryngeal edema and acute laryngopharyngitis in 2 cases, and acute subglottic laryngitis and perichondritis of the auricle in one case. In a private clinic, observation of the laryngopharynx with a flexible endoscope fitted with a CCD (Charge–coupled device) image sensor and palpation of the neck were indispensable to the diagnosis of these diseases often complicating acute laryngopharyngitis and/or lymphadenitis of the neck. After earlier detection of these disease, the rate of treatment-completion without hospitalization in this one private clinic for drip infusion of antibiotics with or without corticosteroid complemented with oral antibiotics was 88%. Injected antibiotics were CTRX (Ceftriaxone Sodium) in 5 cases, PIPC (Piperacillin Sodium) in 6 cases, FOM (Fosfomycin Sodium) in 11cases, and PIPC combined with FOM in 4 cases of critical infection. A single dose of corticosteroid in 11 cases with severe inflammation was 300 mg or 600 mg of hydrocortisone sodium succinate. With the good cooperation between hospitals and clinics, improving the treatment-completion rate in clinics could have contributed to reduce not only the burden on hospital doctors but also the medical expenditure.
