Peritonsillar infection in Christchurch 2006-2008: epidemiology and microbiology

Abstract

Aim: Peritonsillar infection is a complication of acute tonsillitis. It is common and complications can be life-threatening. This study audits all cases of peritonsillar infection presenting to our unit between 2006 and 2008 in order to determine if the epidemiology, bacteriology and antibiotic sensitivity has changed since previous audits in our unit in 1981-1984 and 1990-1992.

Methods: Retrospective chart review.

Results: 213 patients were admitted acutely with peritonsillar infection between January 2006 and December 2008. The average age was 29 years with 30.5% patients in the modal age group of 15-19 years. Male to female ratio was 1.5:1. 54% presented with their first episode. 39% received antibiotics prior to presentation. In two-thirds of cases, the duration of admission was less than 24 hours. Culture results were obtained from 69% of specimens. Cultures mostly contained mixed anaerobic and aerobic bacteria. The most common aerobes were streptococcal species. Organisms were almost uniformly sensitive to penicillin. 21% of patients subsequently underwent tonsillectomy, usually as a delayed procedure.

Conclusion: Peritonsillar infection is a common complication of tonsillitis and can be life-threatening. The number of cases presenting at Christchurch Hospital has increased disproportionate to the population increase since the previous audits. Culture results demonstrate a preponderance of mixed organisms, which may be pathological. Organisms and their sensitivities have not changed since the previous audits. Infection usually responds favourably to drainage in combination with penicillin as the first-line antimicrobial agent.