Research Day
OUTCOMES OF MEDICAL VERSUS SURGICAL THERAPY FOR PERITONSILLAR ABSCESS
Document Type
Abstract
Date
2021
Abstract
Background: Peritonsillar abscess (PTA) is as a relatively common deep neck space infection that may progress to airway compromise and sepsis if managed incorrectly. Surgical therapy (ST) such as incision and drainage is the mainstay of therapy for PTA, but recent data shows that medical therapy (MT) with antibiotics and steroids alone may be equivalent. Bronson Methodist Hospital is among several institutions that have shifted towards this approach.
Objective: To evaluate the clinical characteristics and rate of treatment failure for MT and ST in patients presenting to the Bronson Emergency Department (ED) for PTA. Study Design: Retrospective Cohort
Methods: All PTA diagnoses in the Bronson ED from 2012 to 2019 were identified via International Classification of Diseases codes 475 (9th edition) and J36 (10th edition). Failure rates for each group were calculated with a 95% confidence interval. Patient demographics, clinical presentation, and abscess size were summarized for each group.
Results: 467 patients met inclusion criteria. 172 were randomly selected for preliminary analysis of which 126 (72%) underwent MT while 46 (28%) received ST. The rate of treatment failure was 7.1% [95% CI 3.3, 13.1] in the MT group and 8.7% [95% CI 2.4, 20.8] in the ST group.
Conclusion: Preliminary analysis supports the hypothesis that MT may be equivalent to ST in the management of PTA. This represents a major shift in the management of PTA, which could greatly decrease the healthcare cost and patient discomfort associated with surgical therapy for PTA.