Clinical evaluation of antibiotic regimens in patients with surgically verified parapharyngeal abscess: a prospective observational study

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Clinical evaluation of antibiotic regimens in patients with surgically verified parapharyngeal abscess: a prospective observational study. / Klug, Tejs Ehlers; Andersen, Camilla; Hahn, Pernille; Danstrup, Christian Sander; Petersen, Niels Krintel; Mikkelsen, Sophie; Døssing, Helle; Christensen, Anne-Louise; Rusan, Maria; Kjeldsen, Anette; Greve, Thomas.

In: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 01.07.2021.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

Harvard

Klug, TE, Andersen, C, Hahn, P, Danstrup, CS, Petersen, NK, Mikkelsen, S, Døssing, H, Christensen, A-L, Rusan, M, Kjeldsen, A & Greve, T 2021, 'Clinical evaluation of antibiotic regimens in patients with surgically verified parapharyngeal abscess: a prospective observational study', European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. https://doi.org/10.1007/s00405-021-06962-8

APA

Klug, T. E., Andersen, C., Hahn, P., Danstrup, C. S., Petersen, N. K., Mikkelsen, S., Døssing, H., Christensen, A-L., Rusan, M., Kjeldsen, A., & Greve, T. (2021). Clinical evaluation of antibiotic regimens in patients with surgically verified parapharyngeal abscess: a prospective observational study. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. https://doi.org/10.1007/s00405-021-06962-8

CBE

Klug TE, Andersen C, Hahn P, Danstrup CS, Petersen NK, Mikkelsen S, Døssing H, Christensen A-L, Rusan M, Kjeldsen A, Greve T. 2021. Clinical evaluation of antibiotic regimens in patients with surgically verified parapharyngeal abscess: a prospective observational study. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. https://doi.org/10.1007/s00405-021-06962-8

MLA

Klug, Tejs Ehlers et al. "Clinical evaluation of antibiotic regimens in patients with surgically verified parapharyngeal abscess: a prospective observational study". European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2021. https://doi.org/10.1007/s00405-021-06962-8

Vancouver

Klug TE, Andersen C, Hahn P, Danstrup CS, Petersen NK, Mikkelsen S et al. Clinical evaluation of antibiotic regimens in patients with surgically verified parapharyngeal abscess: a prospective observational study. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2021 Jul 1. https://doi.org/10.1007/s00405-021-06962-8

Author

Klug, Tejs Ehlers ; Andersen, Camilla ; Hahn, Pernille ; Danstrup, Christian Sander ; Petersen, Niels Krintel ; Mikkelsen, Sophie ; Døssing, Helle ; Christensen, Anne-Louise ; Rusan, Maria ; Kjeldsen, Anette ; Greve, Thomas. / Clinical evaluation of antibiotic regimens in patients with surgically verified parapharyngeal abscess: a prospective observational study. In: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2021.

Bibtex

@article{f9a2ff7396304dfd97815c003c0d74c5,
title = "Clinical evaluation of antibiotic regimens in patients with surgically verified parapharyngeal abscess: a prospective observational study",
abstract = "PURPOSE: We aimed to evaluate the effectiveness of different antibiotic regimens for the treatment of parapharyngeal abscess (PPA) and characterize patients, who suffered potentially preventable complications (defined as death, abscess recurrence, spread of infection, or altered antibiotic treatment because of insufficient progress).METHODS: Sixty adult patients with surgically verified PPA were prospectively enrolled at five Danish Ear-nose-throat departments.RESULTS: Surgical treatment included internal incision (100%), external incision (13%), and tonsillectomy (88%). Patients were treated with penicillin G ± metronidazole (n = 39), cefuroxime ± metronidazole (n = 16), or other antibiotics (n = 5). Compared to penicillin-treated patients, cefuroxime-treated patients were hospitalized for longer (4.5 vs 3.0 days, p = 0.007), were more frequently admitted to intensive care (56 vs 15%, p = 0.006), underwent external incision more frequently (31 vs 5%, p = 0.018), and suffered more complications (50 vs 18%, p = 0.022), including re-operation because of abscess recurrence (44 vs 3%, p < 0.001). Nine patients suffered potentially preventable complications. These patients displayed significantly higher C-reactive protein levels, received antibiotics prior to admission more frequently, underwent external incision more commonly, and were admitted to intensive care more frequently compared to other patients.CONCLUSION: The majority of patients with PPA were effectively managed by abscess incision, tonsillectomy, and penicillin G ± metronidazole. Cefuroxime-treated patients were more severely ill at time of admission and had worse outcome compared to penicillin-treated patients. We recommend penicillin G + metronidazole as standard treatment for patients with PPA, but in cases with more risk factors for potentially preventable complications, we recommend aggressive surgical and broadened antibiotic therapy, e.g. piperacillin-tazobactam.",
author = "Klug, {Tejs Ehlers} and Camilla Andersen and Pernille Hahn and Danstrup, {Christian Sander} and Petersen, {Niels Krintel} and Sophie Mikkelsen and Helle D{\o}ssing and Anne-Louise Christensen and Maria Rusan and Anette Kjeldsen and Thomas Greve",
year = "2021",
month = jul,
day = "1",
doi = "10.1007/s00405-021-06962-8",
language = "English",
journal = "European Archives of Oto-Rhino-Laryngology",
issn = "0937-4477",
publisher = "Springer",

}

RIS

TY - JOUR

T1 - Clinical evaluation of antibiotic regimens in patients with surgically verified parapharyngeal abscess: a prospective observational study

AU - Klug, Tejs Ehlers

AU - Andersen, Camilla

AU - Hahn, Pernille

AU - Danstrup, Christian Sander

AU - Petersen, Niels Krintel

AU - Mikkelsen, Sophie

AU - Døssing, Helle

AU - Christensen, Anne-Louise

AU - Rusan, Maria

AU - Kjeldsen, Anette

AU - Greve, Thomas

PY - 2021/7/1

Y1 - 2021/7/1

N2 - PURPOSE: We aimed to evaluate the effectiveness of different antibiotic regimens for the treatment of parapharyngeal abscess (PPA) and characterize patients, who suffered potentially preventable complications (defined as death, abscess recurrence, spread of infection, or altered antibiotic treatment because of insufficient progress).METHODS: Sixty adult patients with surgically verified PPA were prospectively enrolled at five Danish Ear-nose-throat departments.RESULTS: Surgical treatment included internal incision (100%), external incision (13%), and tonsillectomy (88%). Patients were treated with penicillin G ± metronidazole (n = 39), cefuroxime ± metronidazole (n = 16), or other antibiotics (n = 5). Compared to penicillin-treated patients, cefuroxime-treated patients were hospitalized for longer (4.5 vs 3.0 days, p = 0.007), were more frequently admitted to intensive care (56 vs 15%, p = 0.006), underwent external incision more frequently (31 vs 5%, p = 0.018), and suffered more complications (50 vs 18%, p = 0.022), including re-operation because of abscess recurrence (44 vs 3%, p < 0.001). Nine patients suffered potentially preventable complications. These patients displayed significantly higher C-reactive protein levels, received antibiotics prior to admission more frequently, underwent external incision more commonly, and were admitted to intensive care more frequently compared to other patients.CONCLUSION: The majority of patients with PPA were effectively managed by abscess incision, tonsillectomy, and penicillin G ± metronidazole. Cefuroxime-treated patients were more severely ill at time of admission and had worse outcome compared to penicillin-treated patients. We recommend penicillin G + metronidazole as standard treatment for patients with PPA, but in cases with more risk factors for potentially preventable complications, we recommend aggressive surgical and broadened antibiotic therapy, e.g. piperacillin-tazobactam.

AB - PURPOSE: We aimed to evaluate the effectiveness of different antibiotic regimens for the treatment of parapharyngeal abscess (PPA) and characterize patients, who suffered potentially preventable complications (defined as death, abscess recurrence, spread of infection, or altered antibiotic treatment because of insufficient progress).METHODS: Sixty adult patients with surgically verified PPA were prospectively enrolled at five Danish Ear-nose-throat departments.RESULTS: Surgical treatment included internal incision (100%), external incision (13%), and tonsillectomy (88%). Patients were treated with penicillin G ± metronidazole (n = 39), cefuroxime ± metronidazole (n = 16), or other antibiotics (n = 5). Compared to penicillin-treated patients, cefuroxime-treated patients were hospitalized for longer (4.5 vs 3.0 days, p = 0.007), were more frequently admitted to intensive care (56 vs 15%, p = 0.006), underwent external incision more frequently (31 vs 5%, p = 0.018), and suffered more complications (50 vs 18%, p = 0.022), including re-operation because of abscess recurrence (44 vs 3%, p < 0.001). Nine patients suffered potentially preventable complications. These patients displayed significantly higher C-reactive protein levels, received antibiotics prior to admission more frequently, underwent external incision more commonly, and were admitted to intensive care more frequently compared to other patients.CONCLUSION: The majority of patients with PPA were effectively managed by abscess incision, tonsillectomy, and penicillin G ± metronidazole. Cefuroxime-treated patients were more severely ill at time of admission and had worse outcome compared to penicillin-treated patients. We recommend penicillin G + metronidazole as standard treatment for patients with PPA, but in cases with more risk factors for potentially preventable complications, we recommend aggressive surgical and broadened antibiotic therapy, e.g. piperacillin-tazobactam.

U2 - 10.1007/s00405-021-06962-8

DO - 10.1007/s00405-021-06962-8

M3 - Journal article

C2 - 34196735

JO - European Archives of Oto-Rhino-Laryngology

JF - European Archives of Oto-Rhino-Laryngology

SN - 0937-4477

ER -