From the Research
The most common bacteria causing peritonsillar abscess are Streptococcus pyogenes, Fusobacterium species, and other anaerobes, with polymicrobial infections being prevalent, as indicated by the most recent study 1.
Bacterial Causes of Peritonsillar Abscess
The bacterial causes of peritonsillar abscess are diverse, including both aerobic and anaerobic bacteria.
- Streptococcus pyogenes is a common cause, isolated in 29% of cases in one study 1.
- Fusobacterium species, including Fusobacterium necrophorum, are also frequently isolated, with a prevalence of 47% in the same study 1.
- Other anaerobes like Actinomyces species and Peptostreptococcus are also commonly found.
- The polymicrobial nature of these infections, with a mix of aerobic and anaerobic bacteria, is a key factor in their treatment, as it often requires broad-spectrum antibiotics.
Treatment Implications
The treatment of peritonsillar abscess typically involves drainage of the abscess, either through needle aspiration or incision and drainage, alongside antibiotic therapy.
- Empiric antibiotic therapy may include amoxicillin-clavulanate or clindamycin, given the polymicrobial nature of the infection and the need to cover both aerobic and anaerobic bacteria 1, 2.
- The choice of antibiotic should be guided by the results of microbiological cultures, when available, to ensure appropriate coverage of the causative organisms.
Clinical Considerations
In clinical practice, the management of peritonsillar abscess requires consideration of the potential for complications, such as abscess rupture or spread of infection, and the need for prompt and effective treatment to prevent these outcomes.
- The use of broad-spectrum antibiotics, as suggested by the most recent evidence 1, reflects the polymicrobial nature of these infections and the importance of covering a wide range of potential pathogens.
- The role of microbiological examination in guiding antibiotic therapy is also highlighted, particularly in cases where the infection does not respond to initial empiric treatment 1.