1. Impact of anti-inflammatory drug consumption in peritonsillar abscesses: a retrospective cohort study.
- Author
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Feasson T, Debeaupte M, Bidet C, Ader F, Disant F, Ferry T, Chidiac C, and Valour F
- Subjects
- Adult, Amoxicillin-Potassium Clavulanate Combination therapeutic use, Anti-Bacterial Agents therapeutic use, Ceftriaxone therapeutic use, Female, Humans, Male, Metronidazole therapeutic use, Peritonsillar Abscess drug therapy, Peritonsillar Abscess microbiology, Retrospective Studies, Streptococcus isolation & purification, Adrenal Cortex Hormones adverse effects, Anti-Inflammatory Agents adverse effects, Peritonsillar Abscess chemically induced
- Abstract
Background: The experience of clinicians in charge of the in-hospital management of peritonsillar abscesses supports the association between severe forms and anti-inflammatory drug (AID) consumption. However, this observation is based on a limited number of clinical studies. Our objective was to assess the prevalence and impact of AID consumption in patients with peritonsillar abscesses., Methods: All patients referred to the ear, nose and throat surgery department for a peritonsillar abscess were included in a retrospective cohort study (2012-2014)., Results: Among the 216 included patients (male, 55 %; median age, 32 years [IQR, 26-40]), 127 had received AID (59 %), including corticosteroids (n = 67, 31 %) and/or non-steroidal AIDs (NSAIDs, n = 76, 35 %). 199 patients (92 %) benefit from a puncture and 5 (2 %) from a surgery under general anesthesia, associated with ceftriaxone/metronidazole (51 %) or amoxicillin/clavulanic acid (46 %). An iterative surgical procedure was required in 93 cases (43 %), including 19 % under general anesthesia. Bacteriological analysis (79 %) mainly disclosed streptococci (66 %) of A (18 %) and/or milleri (33 %) groups. The prevalence of anaerobes was higher in patients using AIDs (46 % versus 29 %, p = 0.034), regardless of prior antibiotic therapy. 65 patients benefited from a CT-scan; AID consumption was associated with larger abscesses (6.8 [IQR, 3.7-12.7] versus 2.9 [IQR, 0.9-7.8] cm(3); p = 0.005). AID consumption was not a risk factor of iterative surgical procedure., Conclusions: In comparison to the prescribing habits in uncomplicated upper respiratory tract infection, the high prevalence of AID consumption in patients with peritonsillar suppuration suggests a role of AIDs in promoting these complications.
- Published
- 2016
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