Use of steroids in the treatment of peritonsillar abscess

Özbek, Cem; Aygenç, Erdinç; Tuna, Evrim Unsal; Selçuk, Adın; Özdem, Cafer

doi:10.1258/002221504323219563

Cited by 76 publications

(45 citation statements)

References 9 publications

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“…Oral dexamethasone (Olympia et al, 2005 Level II; Niland et al, 2006 Level II) or IM betamethasone (Marvez-Valls et al, 1998 Level II) significantly reduced dysphagia and the duration of symptoms in patients with severe streptococcal pharyngitis, although a study in children failed to find any benefit with oral dexamethasone (Bulloch et al, 2003 Level II). Following drainage and antibiotics for peritonsillar abscess, a single dose of IV steroid reduced pain, trismus and fever (Ozbek et al, 2004 Level II).…”

Section: Acute Pain Associated With Pharyngitismentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. Design: A pragmatic, multicentre, randomised, assessor‐blinded, equivalence and non‐inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10‐point verbal numerical rating scale (VNRS) of at least 4. Main outcome measures: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. Results: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non‐inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention‐to‐treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between‐group differences. Conclusion: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

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Section: Acute Pain Associated With Pharyngitismentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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“…86 Although these trials excluded suspected peritonsillar abscess, in another study of 62 patients with peritonsillar abscesses receiving needle drainage and antibiotics, corticosteroid therapy produced more rapid defervescence, recovery of normal swallowing, relief of trismus, and hospital discharge. 92 …”

Section: Pharyngitis and Peritonsillar Abscessmentioning

confidence: 99%

Use of Corticosteroids in Treating Infectious Diseases

McGee¹

2008

Arch Intern Med

105

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linicians have generally avoided prescribing corticosteroids for active infection because of their known immunosuppressive effects and concern about long-term complications. We conducted a review of the published randomized, double-blind trials comparing corticosteroids and placebo in infections. Except in some trials of viral infections, sore throat, and cerebral cysticercosis, all patients also received active antimicrobial agents in addition to placebo or corticosteroids. For patients with bacterial meningitis, tuberculous meningitis, tuberculous pericarditis, severe typhoid fever, tetanus, or pneumocystis pneumonia with moderate to severe hypoxemia, treatment with corticosteroids improved patient survival (group 1 infections). For patients with bacterial arthritis, corticosteroids were also beneficial and reduced long-term disability (group 2 infections). For about a dozen other infections, corticosteroids significantly relieved symptoms (group 3 infections), and clinicians should consider using them if symptoms are substantial. Corticosteroids were harmful in 2 infections, viral hepatitis and cerebral malaria (group 5 infections). We conclude that corticosteroids are beneficial and safe for a wide variety of infections, although courses longer than 3 weeks should be withheld from patients with concomitant human immunodeficiency virus infection and low CD4 counts.

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“…use of steroids and choice of antibiotics) and surgical technique. [3][4][5][6][7][8][9][10][11][12][13] Immediate tonsillectomy remains controversial, although several publications have reported the efficacy and safety of this technique as first-line treatment for peritonsillar abscess. [14][15][16][17][18][19][20][21] Immediate tonsillectomy has become a routine procedure for the management of peritonsillar abscess in our department, since its introduction in early 2007.…”

Section: Introductionmentioning

confidence: 99%

Immediate tonsillectomy: indications for use as first-line surgical management of peritonsillar abscess (quinsy) and parapharyngeal abscess

et al. 2010

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Immediate tonsillectomy appears to be a safe and effective surgical technique for the management of peritonsillar and parapharyngeal abscess; in particular, it markedly reduces patients' hospital stay (when performed early in the course of the disease) and duration of antibiotic therapy. Immediate tonsillectomy has become the first-line treatment for parapharyngeal abscess and several types of peritonsillar abscess in our department.

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Use of steroids in the treatment of peritonsillar abscess

Cited by 76 publications

References 9 publications

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Use of Corticosteroids in Treating Infectious Diseases

Immediate tonsillectomy: indications for use as first-line surgical management of peritonsillar abscess (quinsy) and parapharyngeal abscess

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