CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2022; 26(04): e585-e591
DOI: 10.1055/s-0042-1744042
Original Research

Antibiotic Resistance Pattern in Pediatric Deep Neck Space Infection

1   Department of ENT - Head and Neck Surgery, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
,
1   Department of ENT - Head and Neck Surgery, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
,
1   Department of ENT - Head and Neck Surgery, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
› Author Affiliations

Abstract

Introduction Neck space infection in the pediatric age group is common but can be life-threatening if not diagnosed properly. Since it is a polymicrobial disease, antibiotic usage should be guided by culture sensitivity pattern.

Objectives To assess the microbiology, antibiotic resistance pattern and the outcome of the medical and surgical management of deep neck space infection in children.

Methods This was a prospective study of children admitted for management of neck space infection from August 2017 to August 2018. The age, gender, organisms isolated, sensitivity and resistance to antibiotics, length of hospital stay, complications, and recurrence were noted. The descriptive data were analyzed.

Results Out of 108 cases, there were 51 males (47.2%) and 57 females (52.8%) ranging from 1 month to 15 years, with a mean age of 5.32 +/− 4.35 years. The mean period of hospitalization was 6.98 days. Staphylococcus aureus was the most common organism isolated with less coagulase-negative staphylococci and streptococci. Clindamycin was the most sensitive drug (82.35%) followed by vancomycin and cloxcillin, while amoxicillin/ampicillin, a commonly used drug, was the least sensitive (20.58%). The abscess recurrence rate was 9.28%. The outcomes of either medical treatment or a combined medical or surgical treatment in properly selected cases were comparable.

Conclusion Clindamycin or cloxacillin can be used as a first-line option for neck infection in children. Ampicillin/amoxicillin alone has a small role in neck abscess because of high resistance to this type of antibiotic.

Ethical Consideration

Ethical clearance was obtained from the institutional review board with approval number 10 (6–11) E[2]77/78.




Publication History

Received: 13 August 2020

Accepted: 20 October 2021

Article published online:
09 February 2022

© 2022. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 
  • References

  • 1 Elden LM, Grundfast KM, Vezina G. Accuracy and usefulness of radiographic assessment of cervical neck infections in children. J Otolaryngol 2001; 30 (02) 82-89
  • 2 Patigaroo SA, Patigaroo FA, Mehfooz N, Khan NA, Kirmani MH. Shakeel. Paediatric Deep Neck Space Abscesses: A Prospective Observational Study. Emerg Med 2012; 2 (117) 2-7 DOI: 10.4172/2165-7548.1000117.
  • 3 Vieira F, Allen SM, Stocks RM, Thompson JW. Deep neck infection. Otolaryngol Clin North Am 2008; 41 (03) 459-483 , vii
  • 4 Rustom IK, Sandoe JA, Makura ZG. Paediatric neck abscesses: microbiology and management. J Laryngol Otol 2008; 122 (05) 480-484
  • 5 Lawrence R, Bateman N. Controversies in the management of deep neck space infection in children: an evidence-based review. Clin Otolaryngol 2017; 42 (01) 156-163
  • 6 Lee YQ, Kanagalingam J. Bacteriology of deep neck abscesses: a retrospective review of 96 consecutive cases. Singapore Med J 2011; 52 (05) 351-355
  • 7 Metin Ö, Öz FN, Tanır G. et al. Deep neck infections in children: experience in a tertiary care center in Turkey. Turk J Pediatr 2014; 56 (03) 272-279
  • 8 Nagy M, Pizzuto M, Backstrom J, Brodsky L. Deep neck infections in children: a new approach to diagnosis and treatment. Laryngoscope 1997; 107 (12 Pt 1): 1627-1634
  • 9 Coticchia JM, Getnick GS, Yun RD, Arnold JE. Age-, site-, and time-specific differences in pediatric deep neck abscesses. Arch Otolaryngol Head Neck Surg 2004; 130 (02) 201-207
  • 10 Nepal G, Bhatta S. Self-medication with antibiotics in WHO Southeast Asian Region: a systematic review. Cureus 2018; 10 (04) e2428
  • 11 Brook I. Microbiology and principles of antimicrobial therapy for head and neck infections. Infect Dis Clin North Am 2007; 21 (02) 355-391 , vi
  • 12 Chen CJ, Huang YC. New epidemiology of Staphylococcus aureus infection in Asia. Clin Microbiol Infect 2014; 20 (07) 605-623
  • 13 Bebell LM, Muiru AN. Antibiotic use and emerging resistance: how can resource-limited countries turn the tide?. Glob Heart 2014; 9 (03) 347-358
  • 14 Baldassari CM, Howell R, Amorn M, Budacki R, Choi S, Pena M. Complications in pediatric deep neck space abscesses. Otolaryngol Head Neck Surg 2011; 144 (04) 592-595
  • 15 Elsherif AM, Park AH, Alder SC, Smith ME, Muntz HR, Grimmer F. Indicators of a more complicated clinical course for pediatric patients with retropharyngeal abscess. Int J Pediatr Otorhinolaryngol 2010; 74 (02) 198-201
  • 16 Ossowski K, Chun RH, Suskind D, Baroody FM. Increased isolation of methicillin-resistant Staphylococcus aureus in pediatric head and neck abscesses. Arch Otolaryngol Head Neck Surg 2006; 132 (11) 1176-1181
  • 17 Oh JH, Kim Y, Kim CH. Parapharyngeal abscess: comprehensive management protocol. ORL J Otorhinolaryngol Relat Spec 2007; 69 (01) 37-42
  • 18 Thompson JW, Cohen SR, Reddix P. Retropharyngeal abscess in children: a retrospective and historical analysis. Laryngoscope 1988; 98 (6 Pt 1): 589-592