title: Gram staining for the treatment of peritonsillar abscess.
abstract: Objective. To examine whether Gram staining can influence the choice of antibiotic for the treatment of peritonsillar abscess. Methods. Between 2005 and 2009, a total of 57 cases of peritonsillar abscess were analyzed with regard to cultured bacteria and Gram staining. Results. Only aerobes were cultured in 16% of cases, and only anaerobes were cultured in 51% of cases. Mixed growth of aerobes and anaerobes was observed in 21% of cases. The cultured bacteria were mainly aerobic Streptococcus, anaerobic Gram-positive cocci, and anaerobic Gram-negative rods. Phagocytosis of bacteria on Gram staining was observed in 9 cases. The bacteria cultured from these cases were aerobic Streptococcus, anaerobic Gram-positive cocci, and anaerobic Gram-negative rods. The sensitivity of Gram staining for the Gram-positive cocci and Gram-negative rods was 90% and 64%, respectively. The specificity of Gram staining for the Gram-positive cocci and Gram-negative rods was 62% and 76%, respectively. Most of the Gram-positive cocci were sensitive to penicillin, but some of anaerobic Gram-negative rods were resistant to penicillin. Conclusion. When Gram staining shows only Gram-positive cocci, penicillin is the treatment of choice. In other cases, antibiotics effective for the penicillin-resistant organisms should be used.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Osaka University Graduate, 2-1 Yamadaoka, Suita, Osaka 565-0871, Japan.
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Takenaka
authors.forename: Kazuya
authors.initials: K
authors.lastname: Takeda
authors.forename: Tadashi
authors.initials: T
authors.lastname: Yoshii
authors.forename: Michiko
authors.initials: M
authors.lastname: Hashimoto
authors.forename: Hidenori
authors.initials: H
authors.lastname: Inohara