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Microbiology and antibiotic resistance of peritonsillar abscess
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Treating peritonsillar abscess is not only a surgical problem, but needs also a calculate antibiotic medication. Therefore it is important to dispose of knowledge about the actual bacteriological flora and the antibiotic resistance of the bacteria.
For this purpose we analyzed the results of the microbiological specimens by 129 patients with a diagnosis of peritonsillar abscess between January 2003 and October 2004.
The average age of these patients was 32 years, including 76 males and 53 females. All of these patients underwent a tonsillectomy in the acute stage within the first 24 hours after admission. Intraoperativ pus swab was taken.
In 42 cases an ambulant antibiotic treatment was initiated. A negative culture was obtained in 2 specimens. Only aerobic bacteria were cultured from 103 specimens, only anerobic bacteria in 2 and in 22 specimens both aerobic/anaerobic species grew. A total of 262 bacteria were recovered.
The predominant bacteria isolates were Streptococcus viridans in 71% of the cases, which are a part of the commensal flora. Coagulase-negative Staphylococcus were cultured in 24% of specimens, Streptococcus pyogenes in 20%, Hämophilus sp. in 13% and Staphylococcus aureus in 12%.
The penicillin resistant Staphylococcus amounted to 46%. A aminopenicillin/ beta-lactamase inhibitor combination or a cephalosporin of the second-generation shows the lowest resistance rate of all aerobic and anaerobic isolates. Before starting treatment this knowledge should be considered.
