Klinisches Management des Peritonsillarabszesses bei pädiatrischen Patienten

Introduction: Peritonsillar abscess (PTA) is a common infection encountered by otorhinolaryngology specialists and pediatric primary care providers, with the potential for serious complications. In pediatric cases, tonsillectomy, alongside antibiotic therapy, remains the only effective surgical option, since alternatives like fine needle aspiration are not feasable due to non-compliance. This study aims to investigate the management of peritonsillar abscesses in pediatric patients reviewing children among our emergencies..

Materials and Methods: We performed a retrospective analysis of 150 pediatric patients treated for peritonsillar abscesses at our institution from 2009 to 2024. Patient records were examined to compare unilateral tonsillectomy (UTE) and bilateral tonsillectomy (BTE) in terms of bleeding risk, complications, recurrence rates for UTE, as well as microbiological flora and antibiotic treatment.

Results: There was no significant difference in postoperative bleeding between the two groups. A recurrent PTA occurred in 4.4% of patients and was treated with UTE. No severe complications were reported post-surgery. Antibiotic treatment mainly relied on Cefuroxime and Ampicillin-Sulbactam, reflecting their broad-spectrum coverage against common pathogens like Streptococcus species and Staphylococcus aureus. Ampicillin-Sulbactam became increasingly favored due to its effectiveness and broader spectrum.

Discussion: In the present study, with a quite large cohort no significant differences between UTE and BTE in pediatric patients were found, irrespective of contralateral abscess or recurrent tonsillitis requiring subsequent surgery. Calculate broad-spectrum antibiotics were appropriately used.

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