Antibiotic Resistance Pattern in Pediatric Deep Neck Space Infection

Abstract

Introduction Neck space infection in the pediatric age group is common but can be life-threatening if not diagnosed properly. Since it is a polymicrobial disease, antibiotic usage should be guided by culture sensitivity pattern. Objectives To assess the microbiology, antibiotic resistance pattern and the outcome of the medical and surgical management of deep neck space infection in children. Methods This was a prospective study of children admitted for management of neck space infection from August 2017 to August 2018. The age, gender, organisms isolated, sensitivity and resistance to antibiotics, length of hospital stay, complications, and recurrence were noted. The descriptive data were analyzed. Results Out of 108 cases, there were 51 males (47.2%) and 57 females (52.8%) ranging from 1 month to 15 years, with a mean age of 5.32 +/− 4.35 years. The mean period of hospitalization was 6.98 days. Staphylococcus aureus was the most common organism isolated with less coagulase-negative staphylococci and streptococci. Clindamycin was the most sensitive drug (82.35%) followed by vancomycin and cloxcillin, while amoxicillin/ampicillin, a commonly used drug, was the least sensitive (20.58%). The abscess recurrence rate was 9.28%. The outcomes of either medical treatment or a combined medical or surgical treatment in properly selected cases were comparable. Conclusion Clindamycin or cloxacillin can be used as a first-line option for neck infection in children. Ampicillin/amoxicillin alone has a small role in neck abscess because of high resistance to this type of antibiotic.

Emerging findings for the assessment and treatment of pediatric deep neck abscesses

“…Three studies published within the past 18 months describe the demographics, clinical features, management, and outcomes of children diagnosed with DNIs [27 ▪ ,28,29 ▪▪ ]. The study by Dona et al [27 ▪ ] retrospectively reviewed 153 children from four individual Italian hospitals who received a diagnosis of either PPA or RPA.…”

“…The study by Kharel et al [29 ▪▪ ] prospectively reviewed 108 children, ages 5 months to 15 years (mean: 5.39 + 4.35) admitted to a single Nepalese hospital for the management of DNI. Fifty-three percent (57/108) of the children were taking antibiotics prior to hospitalization.…”