Possible role of anti-inflammatory drugs in complications of pharyngitis. A retrospective analysis of 163 cases

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Abstract

Complications of pharyngitis (peritonsillar abscess, retropharyngeal abscess, and cervical cel-lulitis) are rare, but appear to be on the increase over recent years and many of these patients havebeen treated by anti-inflammatory drugs prior to admission. The purpose of this study was to review thecurrent epidemiological data concerning these complications and investigate a possible correlation withanti-inflammatory drug use.Material and methods: A single-centre retrospective review of epidemiological, clinical and microbi-ological data was performed on the medical charts of patients hospitalised for peritonsillar abscess,retropharyngeal abscess or cervical cellulitis between 2005 and 2010.Results: Over a six-year period, 163 patients were hospitalised for complications of pharyngitis, with asex-ratio of 1.82 (104/57). The number of cases of peritonsillar abscess (PTA) increased from 13 to 28cases per year from 2005 to 2010 and the number of cases of retropharyngeal abscess increased fromthree to six cases per year over the same period. The number of cases of cellulitis remained stable withan average of 1.82 cases per year. Each year, significantly more patients with an abscess were admittedto our unit with a history of anti-inflammatory drug use (13.3 ± 4.6) than without anti-inflammatorydrug use (7.8 ± 4.3) (P < 0.01). Micro-organisms were identified in 80% of cases, with mixed strains in 73%of cases, Streptococcus in 72% of samples and Streptococcus pyogenes in 19% of cases of PTA. A favourableoutcome was observed in all patients in response to medical and surgical treatment.Conclusion: In line with the literature, we observed an increasing incidence of complications of pharyn-gitis. The present series comprised significantly more patients admitted for PTA with a history ofanti-inflammatory drug use. A multicentre prospective controlled study in Nantes on a large cohortis currently underway and will probably confirm these preliminary results.

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Demeslay, J., De Bonnecaze, G., Vairel, B., Chaput, B., Pessey, J. J., Serrano, E., & Vergez, S. (2014). Possible role of anti-inflammatory drugs in complications of pharyngitis. A retrospective analysis of 163 cases. European Annals of Otorhinolaryngology, Head and Neck Diseases, 131(5), 299–303. https://doi.org/10.1016/j.anorl.2013.08.005

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