title: Peritonsillar abscess (PTA): clinical characteristics, microbiology, drug exposures and outcomes of a large multicenter cohort survey of 412 patients hospitalized in 13 French university hospitals.
abstract: The aim of this study was to describe the epidemiology of hospitalized patients with peritonsillar abscess (PTA). We conducted a multicenter survey in 13 French university hospitals in 2009-2012 describing 412 patients. Median age was 29 year (range, 2-84) and current smoking habit was reported by 177 (43 %) patients. Most of the patients (92 %) had consulted a physician for sore throat within 10 days before admission for PTA diagnosis. Additional symptoms such as visible tonsil abnormalities (83 %), tender cervical adenopathy (57 %) and fever ≥ 38.5 °C (53 %) were also reported. A total of 65 % patients (269/412) reported recent systemic anti-inflammatory agents (AIAs) exposure by medical prescription (70 %), self-medication (22 %), or both (8 %); 61 % and 27 % reported recent exposure to antibiotic and topical treatments for sore throat, respectively. Non-steroidal AIAs were used most often (45 %), particularly arylpropionic derivatives. A rapid diagnosis antigen test (RDT) for Streptococcus pyogenes was performed in 70 (17 %) patients and was positive in 17 (24 %), of whom 9 (53 %) were exposed to AIAs and 14 (82 %) to antibiotics. To treat PTA, antibiotic therapy was given to 392 (95 %) patients. Of 333 antibiotic prescriptions, amoxicillin-clavulanic acid and metronidazole were the most prescribed antibiotics (42 and 17 %, respectively). Surgical drainage of the abscess was performed in 119 (29 %) cases and tonsillectomy in 75 (18 %) cases. The clinical outcome was favorable during the hospital stay in 404 (98 %) patients. In conclusion, patients with sore throat are often exposed to AIAs before PTA diagnosis, and antibiotic prescription was not often based on the RDT positivity.
authors.affiliation: Bacteriology and Infection Control Department, Nantes University Hospital, 44093, Nantes, France. didier.lepelletier@chu-nantes.fr.|Medical School, EA 3826, University of Nantes, 44035, Nantes, France. didier.lepelletier@chu-nantes.fr.
authors.forename: D
authors.initials: D
authors.lastname: Lepelletier
authors.affiliation: Emergency Department, Nantes University Hospital, 44093, Nantes, France.
authors.forename: V
authors.initials: V
authors.lastname: Pinaud
authors.affiliation: Emergency Department, Nantes University Hospital, 44093, Nantes, France.
authors.forename: P
authors.initials: P
authors.lastname: Le Conte
authors.affiliation: Bacteriology and Infection Control Department, Nantes University Hospital, 44093, Nantes, France.
authors.forename: C
authors.initials: C
authors.lastname: Bourigault
authors.affiliation: Infectious Diseases Department, Nantes University Hospital, 44093, Nantes, France.|Medical School, EA 3826, University of Nantes, 44035, Nantes, France.
authors.forename: N
authors.initials: N
authors.lastname: Asseray
authors.affiliation: Medqual, Nantes University Hospital, 44093, Nantes, France.|Medical School, EA 3826, University of Nantes, 44035, Nantes, France.
authors.forename: F
authors.initials: F
authors.lastname: Ballereau
authors.affiliation: Bacteriology and Infection Control Department, Nantes University Hospital, 44093, Nantes, France.|Medical School, EA 3826, University of Nantes, 44035, Nantes, France.
authors.forename: J
authors.initials: J
authors.lastname: Caillon
authors.affiliation: Otorhinolaryngology Department, Nantes University Hospital, 44093, Nantes, France.
authors.forename: C
authors.initials: C
authors.lastname: Ferron
authors.affiliation: Otorhinolaryngology Department, Michallon University Hospital, 38000, Grenoble, France.
authors.forename: C
authors.initials: C
authors.lastname: Righini
authors.affiliation: Emergency Department, Nantes University Hospital, 44093, Nantes, France.|Medical School, EA 3826, University of Nantes, 44035, Nantes, France.
authors.forename: E
authors.initials: E
authors.lastname: Batard
authors.affiliation: Emergency Department, Nantes University Hospital, 44093, Nantes, France.|Medical School, EA 3826, University of Nantes, 44035, Nantes, France.
authors.forename: G
authors.initials: G
authors.lastname: Potel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D005602:France / Q000453:epidemiology; D006760:Hospitalization; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D000039:Peritonsillar Abscess / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents