title: The role of bacteriological studies in the management of peritonsillar abscess.
abstract: OBJECTIVE
  Since most patients with peritonsillar abscess (PTA) can be successfully treated with surgical drainage and empirical antibiotic therapy, routine bacteriologic studies for all patients with PTA may be unnecessary. This study tried to evaluate which patients with PTA should certainly undergo bacteriologic studies.
  
  
  METHODS
  Hundred consecutive patients with PTA were treated and underwent culture tests of purulent contents obtained by surgical drainage between April 2008 and December 2013.
  
  
  RESULTS
  In 62 of the 100 patients, 71 pathogenic bacteria were identified; 61 (86%) were Gram-positive cocci (GPC), 8 (11%) were Gram-negative rods (GNR), and 6 (8%) were anaerobes. Normal flora were isolated in 27 patients, and culture results were negative in 11 patients. Although not significant, primary (without prior antibiotic therapy) case (odds ratio (OR)=2.19; 95% CI, 0.95-5.05) and laryngeal edema (OR=2.04; 95% CI, 0.82-5.03) showed a tendency of associations with detection of pathogenic bacteria. After taking into account interactions between smoking habit and laryngeal edema, the covariate-adjusted OR for non-smokers with laryngeal edema was significant and showed a strong relationship (OR=7.43; 95% confidence interval, 1.05-52.73) compared to non-smokers without laryngeal edema.
  
  
  CONCLUSIONS
  Although empirical antibiotic therapy was effective for most of the PTA patients, bacteriologic studies might be indispensable for the patients with laryngeal edema considering the failure of the first treatments. Particularly, the culture tests may be useful for non-smokers with laryngeal edema.
authors: Department of Otolaryngology, Himeji Red Cross Hospital, 12-1 Shimoteno 1-Chome, Himeji City, Hyogo 670-8540, Japan.
authors: Tomoyasu
authors: T
authors: Tachibana
authors: Department of Otolaryngology, Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama City, Okayama 700-8558, Japan. Electronic address: y.orita@live.jp.
authors: Yorihisa
authors: Y
authors: Orita
authors: Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama City, Okayama 700-8558, Japan.
authors: Soshi
authors: S
authors: Takao
authors: Department of Otolaryngology, Himeji Red Cross Hospital, 12-1 Shimoteno 1-Chome, Himeji City, Hyogo 670-8540, Japan.
authors: Yuya
authors: Y
authors: Ogawara
authors: Department of Otolaryngology, Himeji Red Cross Hospital, 12-1 Shimoteno 1-Chome, Himeji City, Hyogo 670-8540, Japan.
authors: Yuko
authors: Y
authors: Matsuyama
authors: Department of Otolaryngology, Himeji Red Cross Hospital, 12-1 Shimoteno 1-Chome, Himeji City, Hyogo 670-8540, Japan.
authors: Aiko
authors: A
authors: Shimizu
authors: Department of Otolaryngology, Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama City, Okayama 700-8558, Japan.
authors: Iku
authors: I
authors: Abe-Fujisawa
authors: Nakada ENT Clinic, 2-2-20 Shirakuni, Himeji City, Hyogo 670-0808, Japan.
authors: Michihiro
authors: M
authors: Nakada
authors: Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama City, Okayama 700-8558, Japan.
authors: Yasuharu
authors: Y
authors: Sato
authors: Department of Otolaryngology, Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama City, Okayama 700-8558, Japan.
authors: Kazunori
authors: K
authors: Nishizaki
mesh_terms: D000196:Actinomycosis / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016866:Bacteroidaceae Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D002648:Child; D046508:Culture Techniques; D004322:Drainage; D005260:Female; D005674:Fusobacterium Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007819:Laryngeal Edema / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D000039:Peritonsillar Abscess / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy*; D012907:Smoking / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy*; D013290:Streptococcal Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Culture test; Laryngeal edema; Microbiology; Peritonsillar abscess; Smoker