Gram Staining for the Treatment of Peritonsillar Abscess

Abstract

Objective. To examine whether Gram staining can influence the choice of antibiotic for the treatment of peritonsillar abscess. Methods. Between 2005 and 2009, a total of 57 cases of peritonsillar abscess were analyzed with regard to cultured bacteria and Gram staining. Results. Only aerobes were cultured in 16% of cases, and only anaerobes were cultured in 51% of cases. Mixed growth of aerobes and anaerobes was observed in 21% of cases. The cultured bacteria were mainly aerobic Streptococcus, anaerobic Gram-positive cocci, and anaerobic Gram-negative rods. Phagocytosis of bacteria on Gram staining was observed in 9 cases. The bacteria cultured from these cases were aerobic Streptococcus, anaerobic Gram-positive cocci, and anaerobic Gram-negative rods. The sensitivity of Gram staining for the Gram-positive cocci and Gram-negative rods was 90% and 64%, respectively. The specificity of Gram staining for the Gram-positive cocci and Gram-negative rods was 62% and 76%, respectively. Most of the Gram-positive cocci were sensitive to penicillin, but some of anaerobic Gram-negative rods were resistant to penicillin. Conclusion. When Gram staining shows only Gram-positive cocci, penicillin is the treatment of choice. In other cases, antibiotics effective for the penicillin-resistant organisms should be used.

AP-PCR and Antimicrobial Susceptibility Patterns of Fusobacterium nucleatum Associated with Chronic Periodontitis among Patients at Lagos University Teaching Hospital

“…All the isolates were susceptible to cefoxitin, clavulanic acid, clindamycin, metronidazole and tetracycline. This agreed with the findings of some authors (Mosca et al, 2007;Jacinto et al, 2008) but different from others (Serrano et al, 2009;Gomes et al, 2011;Takenaka et al, 2012). However, one isolate (FN 15) was resistant to amoxicillin (MIC > 32 µg/ml) with beta lactamase production.…”

“…The presence of this microorganism in the oral cavity contributes to the initiation and progression of infections particularly in patients with poor oral hygiene. Although commonly considered to belong to the oral microbiota commensals, F. nucleatum species are involved in chronic periodontitis, intrauterine infection and are common isolates in other human disease conditions (Signat et al, 2011, Takenaka et al, 2012, Castellarin et al, 2012.…”

“…The ability to associate these species with a definite periodontal condition may provide a better understanding of their involvements in periodontitis and also assist in epidemiological typing of F. nucleatum during infections especially those involving other body sites. Species of F. nucleatum are susceptible to most antibiotics but resistance exists among different strains (Nyfors et al, 2003;Takenaka, et al, 2012). Like other anaerobes, when Fusobacterium species are involved in infections, treatments are usually empirical.…”

Bacteriology of peritonsillar abscess: the changing trend and predisposing factors

“… Fusobacterium sp. Takenaka et al (2012) 3 Japan 2005–2009 50 Streptococcus pyogenes Anaerobic Streptococcus Fusobacterium sp. Sowerby et al (2013) 14 Canada 2009–2010 42 Group A streptococcus – Streptococcus anginosus Gavriel et al (2015) Israel 1996–2003 132 Streptococcus pyogenes Prevotella sp.…”

Current trend of antibiotic prescription and management for peritonsillar abscess: A cross‐sectional study

“…The authors concluded that despite biases within the studies reviewed, there appeared to be very‐low level evidence pointing to decreased recurrence rates with incision and drainage, and less pain associated with needle aspiration 11 . Given the anaerobic composition of organisms found within PTAs, and the high susceptibility of anaerobic bacteria to oxygen, there are those who have theorized the act of incision and introducing oxygen into the peritonsillar space can have an antibacterial effect 12 …”