Rudhart Stefan Alexander, Send Thorsten, Tilk Maike, Leggewie Barbara, Bosse Franziska, Eichhorn Klaus, Strieth Sebastian, Hoch Stephan, Maas Alexander Philippe
Department of Otorhinolaryngology, University Medical Center Bonn, Bonn, Germany.
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany.
PLoS One. 2025 Jul 7;20(7):e0324276. doi: 10.1371/journal.pone.0324276. eCollection 2025.
Peritonsillar abscess (PTA) is a prevalent infection for specialists in otorhinolaryngology and pediatric primary care providers, that has the potential to cause severe complications. The aim of this study is to investigate the surgical treatment of pediatric peritonsillar abscesses and to compare the risk profiles of bilateral surgery versus surgery on the affected side alone. In addition, the evaluation of the microbiological smears obtained intraoperatively should provide information on whether the calculated antibiotic therapy adequately covers the microbial spectrum.
We conducted a retrospective analysis of pediatric patients (n = 150), who were treated for PTA between 2009 and 2024 by unilateral tonsillectomy (UTE) or bilateral tonsillectomy (BTE). Patient charts were analyzed regarding risk of bleeding, occurrence of other complications, recurrence rates in case of UTE as well as microbiological flora and antibiotic treatment.
Postoperative bleeding did not differ significantly between both groups. In 4.4% of the patients treated by UTE a recurrent PTA was found. No other severe complications after surgical treatment were found. Antibiotic treatment mainly relied on Cefuroxime and Ampicillin-Sulbactam, which is in accordance with the detected microbiological flora.
No relevant differences were found with regard to the complication rate between UTE und BTE in pediatric patients. Broad-spectrum antibiotics were used in accordance with the detected microbiological flora. Since 2019, calculated antibiotic therapy with Ampicillin-Sulbactam has been the treatment of choice for pediatric PTA.
扁桃体周围脓肿（PTA）是耳鼻喉科专家和儿科初级保健提供者常见的感染疾病，有可能导致严重并发症。本研究的目的是调查小儿扁桃体周围脓肿的手术治疗情况，并比较双侧手术与仅患侧手术的风险概况。此外，对术中获得的微生物涂片进行评估应能提供信息，以判断计算得出的抗生素治疗是否能充分覆盖微生物谱。
我们对2009年至2024年间接受单侧扁桃体切除术（UTE）或双侧扁桃体切除术（BTE）治疗PTA的小儿患者（n = 150）进行了回顾性分析。分析患者病历，了解出血风险、其他并发症的发生情况、UTE后的复发率以及微生物菌群和抗生素治疗情况。
两组术后出血情况无显著差异。在接受UTE治疗的患者中，4.4%发现复发性PTA。手术治疗后未发现其他严重并发症。抗生素治疗主要依赖头孢呋辛和氨苄西林-舒巴坦，这与检测到的微生物菌群一致。
小儿患者UTE和BTE的并发症发生率无相关差异。根据检测到的微生物菌群使用了广谱抗生素。自2019年以来，计算得出的氨苄西林-舒巴坦抗生素治疗一直是小儿PTA的首选治疗方法。
