Is there an association between prior anti-inflammatory drug exposure and occurrence of peritonsillar abscess (PTA)? A national multicenter prospective observational case-control study.
The aim of this study was to evaluate whether recent systemic anti-inflammatory agents (AIAs) exposure in patients with sore throat managed with or without antibiotic therapy influenced the risk of peritonsillar abscess (PTA). We conducted a multicenter case-control study in 13 French university hospitals in 2009-2012 comparing patients admitted with PTA to matched controls: patients with sore throat but without PTA who were followed up for 10 days after visiting their primary-care physician. In the multivariate stepwise logistic regression model comparing 120 cases with PTA to 143 controls, factors significantly associated with PTA were male gender (odds ratio [OR], 2.0; p = 0.03), smoking (OR, 2.0; p = 0.03), and prior self-medication with systemic AIAs (OR, 3.5; p = 0.01). Topical treatment was associated with significant protection against PTA (OR, 0.3; p < 0.001). In conclusion, self-medication with systemic AIAs appears to be an independent factor associated with the occurrence of PTA. This is an important message as non-steroidal AIAs access is favored by their over-counter availability in pharmacies. This finding must be interpreted with caution due to the study design and a prospective, randomized study is needed to substantiate these possible causal risk factors.
Bacteriology and Infection Control Department, Nantes University Hospital, 44093, Nantes, France. didier.lepelletier@chu-nantes.fr.|Medical School, MiHAR Lab, University of Nantes, EA 3826, 44035, Nantes, France. didier.lepelletier@chu-nantes.fr.
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D
Lepelletier
Emergency Department, Nantes University Hospital, 44093, Nantes, France.
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V
Pinaud
Emergency Department, Nantes University Hospital, 44093, Nantes, France.
P
P
Le Conte
Bacteriology and Infection Control Department, Nantes University Hospital, 44093, Nantes, France.
C
C
Bourigault
Infectious Diseases Department, Nantes University Hospital, 44093, Nantes, France.|Medical School, MiHAR Lab, University of Nantes, EA 3826, 44035, Nantes, France.
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N
Asseray
Medqual, Nantes University Hospital, 44093, Nantes, France.|Medical School, MiHAR Lab, University of Nantes, EA 3826, 44035, Nantes, France.
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F
Ballereau
Bacteriology and Infection Control Department, Nantes University Hospital, 44093, Nantes, France.|Medical School, MiHAR Lab, University of Nantes, EA 3826, 44035, Nantes, France.
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J
Caillon
Otorhinolaryngology Department, Nantes University Hospital, 44093, Nantes, France.
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C
Ferron
Otorhinolaryngology Department, Michallon University Hospital, 38000, Grenoble, France.
C
C
Righini
Emergency Department, Nantes University Hospital, 44093, Nantes, France.|Medical School, MiHAR Lab, University of Nantes, EA 3826, 44035, Nantes, France.
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E
Batard
Emergency Department, Nantes University Hospital, 44093, Nantes, France.|Medical School, MiHAR Lab, University of Nantes, EA 3826, 44035, Nantes, France.
G
G
Potel
D000293:Adolescent; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D000039:Peritonsillar Abscess / Q000453:epidemiology*; D011446:Prospective Studies; D018570:Risk Assessment; D055815:Young Adult
D000893:Anti-Inflammatory Agents