A retrospective study of peritonsillar abscess in Riyadh Medical Complex toward setting up treatment protocol

OBJECTIVE: To investigate and study the management pattern of peritonsillar abscess, the male to female ratio and incidence. Also, to evaluate the causative organism isolated from abscess and reported by culture/sensitivity (C/S).

METHODS: This study has been designed as a single centered retrospective hospital based study. We carried out this study in the Department of ENT, Riyadh Medical Complex, Saudi Arabia from 2000 to 2004. We gathered the data via survey (5 years). There were 81 patients admitted for the management of peritonsillar abscess.

RESULTS: Mean age of patients was 22 years (range 10 to 60 years; 44 male, 37 female). The hospital stay varies from 1-8 days with a mean of 4 days. The left side is more involved. Treatment consisted mainly incision/drainage under local anesthetic in 47 patients (58%), while 5 cases (6%) were carried out under general anesthetic. Aspiration and conservative treatment was noted in 25 (31%) cases, abscess tonsillectomy was carried out in 3 (4%) cases. The most common microorganisms isolated from C/S is Group A beta hemolytic streptococcus (17/81 [21%]). Penicillin G + Flagyl (49/81 [60%]) were the most common antibiotics used. No case of bilateral peritonsillar abscess was found and there is no consensus regarding the best technique. Options include needle aspiration, incision and drainage and immediate tonsillectomy.

CONCLUSION: Peritonsillar abscess remain one of the acute admission in the Department of Otolaryngology at Riyadh Medical Complex, Riyadh. Incision/drainage remains the gold standard treatment, Penicillin G + Flagyl combinations are the cornerstones.