Deep Neck Space Infections Organism-Specific Therapy 

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Deep Neck Space Infections Organism-Specific Therapy 

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Deep neck space infections, including parapharyngeal abscess, peritonsillar abscess, and retropharyngeal abscess, commonly arise from an odontogenic or upper aerodigestive tract origin. The bacteriology tends to be polymicrobial, involving both aerobic and anaerobic bacteria from the primary source. These infections may be life threatening if not diagnosed and treated promptly, by leading to airway compromise and spread of infection to neighboring compartments. Initial empiric antimicrobial therapy should include broad coverage for beta-lactamase–producing bacteria, including Staphylococcus aureusStreptococcus pyogenes, Streptococcus viridans, anaerobic gram-negative bacilli, and Peptostreptococcus species, until culture results are obtained to help direct treatment. [1, 2, 3, 4, 5, 6, 7] Specific therapy upon obtaining organism and susceptibility information is detailed below.

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Parenteral therapy is indicated until the patient is afebrile, with a clear clinical improvement in symptoms for 48h. Afterwards, the patient may transition to oral antibiotics and complete a 2- to 3-wk course of treatment. Longer courses may be required when complications are present.

See the list below:

Brook I. Microbiology and principles of antimicrobial therapy for head and neck infections. Infect Dis Clin North Am. 2007 Jun. 21(2):355-91, vi. [Medline].

Inman JC, Rowe M, Ghostine M, et al. Pediatric neck abscesses: changing organisms and empiric therapies. Laryngoscope. 2008 Dec. 118(12):2111-4. [Medline].

Vieira F, Allen SM, Stocks RM, et al. Deep neck infection. Otolaryngol Clin North Am. 2008 Jun. 41(3):459-83, vii. [Medline].

Shah UK. Peritonsillar and retropharyngeal abscess. Shah S, ed. Pediatric Practice: Infectious Diseases. Philadelphia, Pa: McGraw-Hill; 2009. 206-15.

Carbone PN, Capra GG, Brigger MT. Antibiotic therapy for pediatric deep neck abscesses: a systematic review. Int J Pediatr Otorhinolaryngol. 2012 Nov. 76(11):1647-53. [Medline].

Motahari SJ, Poormoosa R, Nikkhah M, Bahari M, Shirazy SM, Khavarinejad F. Treatment and prognosis of deep neck infections. Indian J Otolaryngol Head Neck Surg. 2015 Mar. 67 (Suppl 1):134-7. [Medline].

Farmahan S, Tuopar D, Ameerally PJ. A study to investigate changes in the microbiology and antibiotic sensitivity of head and neck space infections. Surgeon. 2014 Apr 27. pii: S1479-666X(14)00021-3. [Medline].

Udayan K Shah, MD, FACS, FAAP Professor of Otolaryngology-Head and Neck Surgery and Pediatrics, Jefferson Medical College, Thomas Jefferson University; Director, Fellow and Resident Education in Pediatric Otolaryngology, Division of Otolaryngology, Nemours-AI duPont Hospital for Children

Udayan K Shah, MD, FACS, FAAP is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Pediatrics, American College of Surgeons, Phi Beta Kappa, American Society of Pediatric Otolaryngology, Society for Ear, Nose and Throat Advances in Children

Disclosure: Nothing to disclose.

Michael B Hall, MD Resident Physician, Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital

Michael B Hall, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery

Disclosure: Nothing to disclose.

Jasmeet Anand, PharmD, RPh Adjunct Instructor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Michael Stuart Bronze, MD David Ross Boyd Professor and Chairman, Department of Medicine, Stewart G Wolf Endowed Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center; Master of the American College of Physicians; Fellow, Infectious Diseases Society of America; Fellow of the Royal College of Physicians, London

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Medical Association, Association of Professors of Medicine, Infectious Diseases Society of America, Oklahoma State Medical Association, Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

Thomas E Herchline, MD Professor of Medicine, Wright State University, Boonshoft School of Medicine; Medical Consultant, Public Health, Dayton and Montgomery County (Ohio) Tuberculosis Clinic

Thomas E Herchline, MD is a member of the following medical societies: Alpha Omega Alpha, Infectious Diseases Society of America, Infectious Diseases Society of Ohio

Disclosure: Nothing to disclose.

Christopher R Grindle, MD Assistant Professor of Clinical Otolaryngology, University of Connecticut School of Medicine

Disclosure: Nothing to disclose.

David E Conrad, MD Fellow in Pediatric Otolaryngology, AI DuPont Hospital for Children

David E Conrad, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery

Disclosure: Nothing to disclose.

Deep Neck Space Infections Organism-Specific Therapy 

Research & References of Deep Neck Space Infections Organism-Specific Therapy |A&C Accounting And Tax Services
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Deep Neck Space Infections Organism-Specific Therapy 

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