the epidemiology, antibiotic resistance and postdischarge course of peritonsillar abscesses in london, ontario流行病学、抗生素耐药性和出院后的扁桃体周脓肿在伦敦、安大略省.pdf

Sowerby et al. Journal of Otolaryngology - Head and Neck Surgery 2013, 42:5 /content/42/1/5 ORIGINAL RESEARCH ARTICLE Open Access The epidemiology, antibiotic resistance and post-discharge course of peritonsillar abscesses in London, Ontario 1 2 1,3* Leigh J Sowerby , Zafar Hussain and Murad Husein Abstract Background: Peritonsillar abscesses (PTA) are a common complication of tonsillitis. Recent global epidemiological data regarding PTAs have demonstrated increasing antimicrobial resistance patterns. No similar studies have been conducted in Canada and no Canadian study has examined the post-discharge course of treated patients. Methods: A prospective observational study of the epidemiology, antibiotic resistance and post-discharge course of patients presenting with a peritonsillar abscess to the Emergency Department in London, Ontario over one year. A follow-up telephone survey was conducted 2–3 weeks after abscess drainage. Results: 60 patients were diagnosed with an abscess, giving an incidence of 12/100,000. 46 patients were enrolled in the study; the average duration of symptoms prior to presentation was 6 days, with 51% treated with antibiotics prior to presentation. Streptococcus pyogenes and Streptococcus anginosus were present in 56% of isolates and of those, 7/23 (32%) of specimens demonstrated resistance to clindamycin. Eight patients were treated with clindamycin and had a culture that was resistant, yet only one had recurrence. Telephone follow-up was possible for 38 patients: 51% of patients reported a return to solid food within 2 days, and 75% reported no pain by 5 days. Resolution of trismus took a week or longer for 51%. Interpretation: Clindamycin resistance was identified in a third of Streptococcus isolates, which should be ta