Evidence map›Paper›PMID 34196735›Full record

Observational studyEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2022

Clinical evaluation of antibiotic regimens in patients with surgically verified parapharyngeal abscess: a prospective observational study.

Tejs Ehlers Klug, Camilla Andersen, Pernille Hahn, Christian Sander Danstrup, Niels Krintel Petersen, Sophie Mikkelsen, Helle Døssing, Anne-Louise Christensen, Maria Rusan, Anette Kjeldsen and 1 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.2field-weighted citation impact, top 47% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 3 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 1 country.

Tejs Ehlers KlugDepartment of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark. tejsehlersklug@hotmail.com.ORCID http://orcid.org/0000-0001-5053-8034
Camilla AndersenDepartment of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark.
Pernille HahnDepartment of Otorhinolaryngology, Head and Neck Surgery, Hospital Lillebaelt, Vejle, Denmark.
Christian Sander DanstrupDepartment of Otorhinolaryngology, Head and Neck Surgery, Aalborg University Hospital, Aalborg, Denmark.
Niels Krintel PetersenDepartment of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark.
Sophie MikkelsenDepartment of Otorhinolaryngology, Head and Neck Surgery, Aalborg University Hospital, Aalborg, Denmark.
Helle DøssingDepartment of Otorhinolaryngology, Head and Neck Surgery, Odense University Hospital, Odense, Denmark.
Anne-Louise ChristensenDepartment of Otorhinolaryngology, Head and Neck Surgery, Regional Hospital, Holstebro, Denmark.
Maria RusanDepartment of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.
Anette KjeldsenDepartment of Otorhinolaryngology, Head and Neck Surgery, Odense University Hospital, Odense, Denmark.
Thomas GreveDepartment of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark.
Aarhus University Hospital · DKAalborg University Hospital · DKOdense University Hospital · DKLillebaelt Hospital · DKRegional Hospital Holstebro · DK

Funding

Lundbeckfonden R185-2014-2482
6 · The paper itself

Abstract

purposeWe aimed to evaluate the effectiveness of different antibiotic regimens for the treatment of parapharyngeal abscess (PPA) and characterize patients, who suffered potentially preventable complications (defined as death, abscess recurrence, spread of infection, or altered antibiotic treatment because of insufficient progress).

methodsSixty adult patients with surgically verified PPA were prospectively enrolled at five Danish Ear-nose-throat departments.

resultsSurgical treatment included internal incision (100%), external incision (13%), and tonsillectomy (88%). Patients were treated with penicillin G ± metronidazole (n = 39), cefuroxime ± metronidazole (n = 16), or other antibiotics (n = 5). Compared to penicillin-treated patients, cefuroxime-treated patients were hospitalized for longer (4.5 vs 3.0 days, p = 0.007), were more frequently admitted to intensive care (56 vs 15%, p = 0.006), underwent external incision more frequently (31 vs 5%, p = 0.018), and suffered more complications (50 vs 18%, p = 0.022), including re-operation because of abscess recurrence (44 vs 3%, p < 0.001). Nine patients suffered potentially preventable complications. These patients displayed significantly higher C-reactive protein levels, received antibiotics prior to admission more frequently, underwent external incision more commonly, and were admitted to intensive care more frequently compared to other patients.

conclusionThe majority of patients with PPA were effectively managed by abscess incision, tonsillectomy, and penicillin G ± metronidazole. Cefuroxime-treated patients were more severely ill at time of admission and had worse outcome compared to penicillin-treated patients. We recommend penicillin G + metronidazole as standard treatment for patients with PPA, but in cases with more risk factors for potentially preventable complications, we recommend aggressive surgical and broadened antibiotic therapy, e.g. piperacillin-tazobactam.

Indexed as

Pharyngeal DiseasesTonsillectomyAbscessAdultAnti-Bacterial AgentsHumansMetronidazoleAnti-Bacterial AgentsMetronidazoleAntibioticsComplicationsEvaluationManagementMicrobiologyParapharyngeal abscess

Identifiers

PMID34196735
OpenAlexW3176549059

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.