Changing Trends of Peritonsillar Abscess.

Objective To assess changes in the characteristics of peritonsillar abscess (PTA). Methods A retrospective cohort study. Data obtained from medical records of patients diagnosed as having a peritonsillar abscess that were treated in a secondary urban medical center over a ten-year period (1998-2007). Results 427 patients, within ages of 3 to 91 years (average 31.6, SD 15.2, median 30) were enrolled. 47 patients (11%) were admitted more than once for PTA. There was no gender, seasonal, or localization predominance. 13 patients (3%) developed PTA complications. 104 patients (24.4%) were 40 years old or older, having a longer hospitalization period, and were more prone to complications. 102 patients (23.9%) did not have acute tonsillitis before PTA evolvement. Smoking was more common among patients than in the general population rate (33% vs 25%), associated with a higher complication. Culture results and antibiotic therapy influence were analyzed for all PTA cases (n=486). In 283 patients (58.2%) developed PTA in spite of a prior antibiotic therapy. Smoking was associated with a higher infection rate by Streptococcus viridans. Conclusions Comparison of current data to earlier reports suggests that PTA has gradually changed its characteristics: affecting older patients, having a more vigorous presentation and a longer course, abscess evolvement without an anteceding tonsillitis, and patients developing PTA in spite of a prior adequate antibiotic therapy. In addition, smoking may be a predisposing factor.