title: [Retro- and parapharyngeal abscess in children: predictive factors of medical treatment failure].
abstract: OBJECTIVE
  To consider the predictive factors of failure after medical treatment (intravenous antibiotics) first initiated in children with retro- and parapharyngeal abscess, without life-threatening complications.
  
  
  METHODS
  Retrospective study between 1998 and 2006 of 45 children treated at the Nantes University Hospital for a retro- and parapharyngeal abscess.
  
  
  RESULTS
  Median age was 3.8 years. Thirty (66%) patients required surgical management. Significant predictive factors of failure of initial medical therapy were: patients under 3 years of age, symptoms more than 3 days before intravenous antibiotic therapy, leukocyte count higher than 22,000 per millimeter cube, hypodensity diameter greater than 20mm, and abscess demonstrated on CT scan. Previous antibiotic therapy at home was not significantly related to medical treatment failure. Broad-spectrum antibiotic therapy associations did not improve medical outcome.
  
  
  CONCLUSIONS
  The predictive factors of failure after initial medical therapy for retro- and/or parapharyngeal abscess in children are underlined; these factors help determine the clinical approach.
authors.affiliation: Service d'ORL et de chirurgie cervicofaciale, CHU Hôtel-Dieu, 1, place Alexis-Ricordeau, BP 1005, 44093 Nantes cedex 01, France.
authors.forename: R
authors.initials: R
authors.lastname: Wagner
authors.forename: F
authors.initials: F
authors.lastname: Espitalier
authors.forename: A
authors.initials: A
authors.lastname: Madoz
authors.forename: G
authors.initials: G
authors.lastname: Picherot
authors.forename: P
authors.initials: P
authors.lastname: Bordure
authors.forename: O
authors.initials: O
authors.lastname: Malard
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007275:Injections, Intravenous; D007958:Leukocyte Count; D000039:Peritonsillar Abscess / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D011237:Predictive Value of Tests; D011859:Radiography; D017703:Retropharyngeal Abscess / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents