Clinical factor for successful nonsurgical treatment of pediatric peritonsillar abscess.

OBJECTIVES/HYPOTHESIS: Current management for peritonsillar abscess in pediatric patients includes intensive medical therapy using antibiotics with or without surgical drainage. However, attaining proper surgical drainage is difficult in young children because they have narrow oral cavities and are less cooperative than adults. The aim of this study was to investigate which factors are associated with a good response to nonsurgical treatment of a pediatric peritonsillar abscess.

STUDY DESIGN: A retrospective analysis.

METHODS: This study included consecutive children who visited our pediatric clinic for the treatment of peritonsillar abscess. All patients initially received medical treatment, and additional surgical treatment was provided if the patient appeared unlikely to recover. Multivariate logistic regression models were constructed to identify factors associated with a good response to nonsurgical treatment. In addition, a receiver operating characteristic curve was used to identify the age cutoff for predicting good treatment response.

RESULTS: A total of 88 children were included the study. Patient age, recurrent tonsillitis, and abscess size were significantly associated with response to nonsurgical treatment (adjusted odds ratios=1.485, 2.403, and 1.325, respectively) after adjusting for sex, body mass index, season, serum C-reactive protein levels, and tonsil grade. The age cutoff associated with good response to nonsurgical treatment was 7.5 years (80.0% sensitivity, 51.5% specificity).

CONCLUSION: Our findings suggest that a younger age, fewer episodes of acute tonsillitis, and smaller abscess size predict a successful response to nonsurgical treatment in children with peritonsillar abscess.

LEVEL OF EVIDENCE: 4.