Peritonsillar abscess in children: A retrospective analysis on surgical and antimicrobial approaches.

Background: Peritonsillar abscess (PTA) is a prevalent infection for specialists in otorhinolaryngology and pediatric primary care providers, that has the potential to cause severe complications. The aim of this study is to investigate the surgical treatment of pediatric peritonsillar abscesses and to compare the risk profiles of bilateral surgery versus surgery on the affected side alone. In addition, the evaluation of the microbiological smears obtained intraoperatively should provide information on whether the calculated antibiotic therapy adequately covers the microbial spectrum.

Methods: We conducted a retrospective analysis of pediatric patients (n = 150), who were treated for PTA between 2009 and 2024 by unilateral tonsillectomy (UTE) or bilateral tonsillectomy (BTE). Patient charts were analyzed regarding risk of bleeding, occurrence of other complications, recurrence rates in case of UTE as well as microbiological flora and antibiotic treatment.

Results: Postoperative bleeding did not differ significantly between both groups. In 4.4% of the patients treated by UTE a recurrent PTA was found. No other severe complications after surgical treatment were found. Antibiotic treatment mainly relied on Cefuroxime and Ampicillin-Sulbactam, which is in accordance with the detected microbiological flora.

Conclusions: No relevant differences were found with regard to the complication rate between UTE und BTE in pediatric patients. Broad-spectrum antibiotics were used in accordance with the detected microbiological flora. Since 2019, calculated antibiotic therapy with Ampicillin-Sulbactam has been the treatment of choice for pediatric PTA.