扁桃周囲膿瘍に対する至適抗菌薬の検討

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  • Optimal Antibiotics for Treating Peritonsillar Abscess
  • 臨床 扁桃周囲膿瘍に対する至適抗菌薬の検討
  • リンショウ ヘントウ シュウイ ノウヨウ ニ タイスル シテキ コウキンヤク ノ ケントウ

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We retrospectively examined the bacterial isolates, tolerance to antibiotics, and clinical course in 88 patients with peritonsillar abscess who were treated at the Matto Ishikawa Public Central Hospital between October 2007 and December 2012. Peritonsillar pus was collected by needle aspiration in 57 cases, and 90 strains of bacteria were detected and tested for drug sensitivity. In 16 cases (32%), only anaerobes were cultured. In 18 cases (35%), only aerobes were cultured. And in 16 cases (28%), both anaerobes and aerobes were cultured. In 3 cases (5%), neither anaerobes nor aerobes were detected. Overall, 6 of the 41 anaerobic strains (14.6%) and 8 of the 35 aerobic strains (22.9%) were resistant to clindamycin(CLDM). None of the 25 anaerobes were resistant to ampicillin/sulbactam (ABPC/SBT). The rate of resistance to ABPC/SBT among the aerobes was less than or equal to the rate of the resistance of aerobes to ABPC (9.8%). Against carbapenem (CBP), all 42 anaerobic strains did not have any tolerance, and only 2 of the 42 aerobes were resistant (4.8%). Judging from the above, ABPC/SBT might be suitable as a first-line antibiotic for the treatment of peritonsillar abscess, rather than CLDM, because of the low rate of drug resistance and the narrow spectrum. CBP should be regarded as a second-line treatment, since CBP abuse can induce tolerance.<br>

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