Peritonsillar Infection in Christchurch – Epidemiology and Microbiology Trends
Callum Davidson, Non-Training Registrar, Christchurch Hospital, New Zealand
Authors List
Introduction
Peritonsillar infection is a common acute pharyngeal pathology, closely linked to tonsillar infection. Previous cohorts from CDHB have had microbiology reviewed, demonstrating that penicillin is a suitable first line antibiotic choice.
Aim
The aim of this study was to review recent microbiology and epidemiological patterns and compare to prior cohorts.
Methods
We performed a retrospective review of electronic records and prescribing for all cases of peritonsillar infection between 2017 and 2019. Data was collected on epidemiology, microbiology and antibiotic use.
Results
398 (431 total admissions) patients were admitted over the 3-year period with peritonsillar cellulitis or abscess. The average age was 32.4 and male to female ratio was 1.28:1. Māori represented 18.8% of cases, despite comprising only 9.9% of the general population.
31.4% were current smokers. 38% received antibiotics prior to admission for an average of 3.7 days, 59% of who received penicillin. 66% of inpatients were treated with penicillin, 23% with Augmentin, with similar proportions discharged on the same, for an average prescribed course of 9.8 days total. Microbiology samples were obtained in 79% of cases, with Beta haemolytic Streptococcus being the most commonly isolated organisms. Fusobacterium was the most common anaerobic organism, isolated in 16% of cases. 30% had either acute tonsillectomy or were waitlisted.
Conclusion
There has been a large increase in the number of cases of peritonsillar infection over time. Compared with Christchurch population growth of 6% and Canterbury 15%, there has been a 85% increase in number of patients requiring admission. Māori are also disproportionately represented. Although beta haemolytic strep and flora predominated, the large increase in anaerobic bacteria such as fusobacterium may warrant broader spectrum antibiotics in select cases, such as those with more severe infection and those slow to respond.
- Davidson, C., Christchurch Hospital, Christchurch, New Zealand
- Love, R., Christchurch Hospital, Christchurch, New Zealand
Introduction
Peritonsillar infection is a common acute pharyngeal pathology, closely linked to tonsillar infection. Previous cohorts from CDHB have had microbiology reviewed, demonstrating that penicillin is a suitable first line antibiotic choice.
Aim
The aim of this study was to review recent microbiology and epidemiological patterns and compare to prior cohorts.
Methods
We performed a retrospective review of electronic records and prescribing for all cases of peritonsillar infection between 2017 and 2019. Data was collected on epidemiology, microbiology and antibiotic use.
Results
398 (431 total admissions) patients were admitted over the 3-year period with peritonsillar cellulitis or abscess. The average age was 32.4 and male to female ratio was 1.28:1. Māori represented 18.8% of cases, despite comprising only 9.9% of the general population.
31.4% were current smokers. 38% received antibiotics prior to admission for an average of 3.7 days, 59% of who received penicillin. 66% of inpatients were treated with penicillin, 23% with Augmentin, with similar proportions discharged on the same, for an average prescribed course of 9.8 days total. Microbiology samples were obtained in 79% of cases, with Beta haemolytic Streptococcus being the most commonly isolated organisms. Fusobacterium was the most common anaerobic organism, isolated in 16% of cases. 30% had either acute tonsillectomy or were waitlisted.
Conclusion
There has been a large increase in the number of cases of peritonsillar infection over time. Compared with Christchurch population growth of 6% and Canterbury 15%, there has been a 85% increase in number of patients requiring admission. Māori are also disproportionately represented. Although beta haemolytic strep and flora predominated, the large increase in anaerobic bacteria such as fusobacterium may warrant broader spectrum antibiotics in select cases, such as those with more severe infection and those slow to respond.
