Peritonsillar infection in Christchurch 1990-2: microbiology and management.

Objective: To review the management and microbiology of peritonsillar infection in Christchurch.

Methods: The hospital records of patients admitted acutely to Christchurch Hospital with peritonsillar infection between January 1990 and December 1992, were reviewed.

Results: 109 patients were admitted with peritonsillar infection, of which 74 (68%) were found to have a peritonsillar abscess. Of these 74, needle aspiration was performed in 22, incision and drainage in 15, both aspiration and drainage in 31, and acute tonsillectomy in 6. Interval tonsillectomy was performed in 35 patients. Sixteen pathogenic bacterial groups or species were cultured from 39 aspirates. Of the total number of bacteria isolates, obligate anaerobes were cultured in 48%, and group A beta-haemolytic streptococci in 29%, while aerobic beta-lactamase producing bacteria were cultured in only 6%.

Conclusions: Central to the management of peritonsillar abscess is drainage. This was commonly achieved by needle aspiration and/or incision. As beta-lactamase producing organisms are infrequent, penicillin remains the antibiotic of choice. Metronidazole may be required in a non responding patient, particularly if resistant anaerobes are cultured.