目的:目前尚无治疗扁桃体周围脓肿(PTA)的一致指南。为了制定最佳实践指南,必须首先建立当前的实践模式。
方法:这是一项横断面研究,测量耳鼻喉科-头颈外科学员(居民和研究员)和顾问(学术和社区)。主要结果是门诊抗生素处方的类型和持续时间。次要结果包括检查的差异,管理,处方,和后续行动。
结果:调查有57名受访者;24名(42%)受训人员(居民/研究员)和33名(58%)顾问。平均而言,在过去一年中,每个受访者平均管理15.2(SD11.2)个PTA。所有受访者都开了口服抗生素,阿莫西林-克拉维酸是最常见的(61%)。受训者比顾问更频繁地处方阿莫西林-克拉维酸(n=21,88%vsn=14,42%,P=.0084),分别。抗生素治疗的持续时间为5至14天。最常见的是,开了10天疗程的抗生素(n=31,54%).关于PTA的管理,大多数受访者要求进行血液检查(n=39,68%),进行针吸(n=42,72%)和切开引流(n=52,91%)。经常进行抽吸/引流液的培养和敏感性(n=41,72%)。患者通常被提供非阿片类镇痛药(n=46,81%),但超过一半的人仍接受处方阿片类药物(n=36,63%).大多数临床医生安排了随访(n=42,74%),最常见于耳鼻咽喉头颈外科(n=27,64%),平均随访12.5(SD8.2)天。
结论:我们发现PTA管理存在异质性,随着门诊抗生素处方的变化。这项研究强调了广泛的管理策略,以及工作的差异,调查,出院后镇痛处方,以及后续安排。
方法:5.
OBJECTIVE: There are no consensus guidelines for managing peritonsillar abscess (PTA) despite its prevalence. In order to devise best practice guidelines, current practice patterns must first be established.
METHODS: This was a cross-sectional
study, surveying Otolaryngology-Head & Neck Surgery trainees (residents and fellows) and consultant (academic and community). The primary outcome was the type and duration of outpatient antibiotic prescription. Secondary outcomes included differences in workup, management, prescription, and follow-up.
RESULTS: There were 57 respondents to the survey; 24 (42%) trainees (residents/fellows) and 33 (58%) consultants. On average, each respondent managed an average of 15.2 (SD 11.2) PTAs within the last year. All respondents prescribed oral antibiotics, with amoxicillin-clavulanic acid being the most common (61%). Trainees prescribed amoxicillin-clavulanic acid more often than consultants (n = 21, 88% vs n = 14, 42%, P = .0084), respectively. Duration of antibiotic therapy ranged from 5 to 14 days. Most commonly, a 10-day course of antibiotics was prescribed (n = 31, 54%). Regarding the management of PTAs, a majority of respondents requested blood work (n = 39, 68%), performed needle aspiration (n = 42, 72%) and performed incision and drainage (n = 52, 91%). Culture and sensitivity of the aspirate/drainage fluid was frequently performed (n = 41, 72%). Patients were often provided non-opioid analgesics (n = 46, 81%), but more than half still received prescription opioids (n = 36, 63%). The majority of clinicians arranged for follow-up (n = 42, 74%), most often with Otolaryngology - Head & Neck Surgery (n = 27, 64%), with an average follow-up of 12.5 (SD 8.2) days.
CONCLUSIONS: We found heterogeneity in the management of PTAs, with variability in the outpatient antibiotic prescription. This
study highlighted the wide range of management strategies employed along with differences in workup, investigation, post-discharge analgesic prescription, and follow-up arrangements.
METHODS: 5.