Peritonsillar Abscess Size as a Predictor of Medical Therapy Success

xlomafota13 shared this article with you from Inoreader Peritonsillar Abscess Size as a Predictor of Medical Therapy Success Via otol rhinol Ann Otol Rhinol Laryngol. 2021 May 12:34894211015590. doi: 10.1177/00034894211015590. Online ahead of print. ABSTRACT OBJECTIVE: To evaluate the success of sole medical therapy (MT) versus surgical therapy (ST) in patients with both clinically and radiographically confirmed peritonsillar abscess (PTA). To also determine treatment safety based on abscess size, and identify predictors of treatment failure. METHODS: This was a retrospective cohort of 3 hospitals in a sing le academic health system. A total of 214 immunocompetent patients diagnosed with uncomplicated PTA underwent a contrasted CT scan of the neck. About 87 patients were treated with sole MT (intravenous antibiotics and steroids), and 127 patients were treated with ST (MT plus drainage). RESULTS: Treatment failure occurred in 8.0% of the MT group and 7.9% of the ST group (P = 1.00). In PTAs <2 cm, treatment failure occurred in 5.3% of the MT group and 5.0% of the ST group (P = 1.00). In PTAs ≥2 cm, treatment failure occurred in 13.3% of the MT group and 9.0% treated with ST (P = .53). Size ≥2 cm (OR - 3.46, P = .08) and IV clindamycin as sole IV antibiotic (OR - 2.46, P = .15) trended toward predicting treatment failure. In addition to those considered failures, 7.0% of the ST group returned to the ED with pain versus 0% of the MT group (P = .01). CONCLUSION: Frequency of treatment failure was not significantly different amon g patients receiving MT and ST. Abscesses ≥2 cm in size were more likely to fail in both groups and ST was not statistically superior. Sole MT for uncomplicated PTA may help reduce unnecessary procedures and healthcare costs. PMID:33980073 | DOI:10.1177/00034894211015590 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.