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International Journal of Otolaryngology
Volume 2012, Article ID 464973, 5 pages
http://dx.doi.org/10.1155/2012/464973
Research Article

Gram Staining for the Treatment of Peritonsillar Abscess

1Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Osaka University Graduate, 2-1 Yamadaoka, Suita, Osaka 565-0871, Japan
2Department of Otolaryngology, Kinki Central Hospital, 3-1 Kurumazuka, Hyogo, Itami 664-8533, Japan

Received 10 November 2011; Accepted 11 December 2011

Academic Editor: Leonard P. Rybak

Copyright © 2012 Yukinori Takenaka et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To examine whether Gram staining can influence the choice of antibiotic for the treatment of peritonsillar abscess. Methods. Between 2005 and 2009, a total of 57 cases of peritonsillar abscess were analyzed with regard to cultured bacteria and Gram staining. Results. Only aerobes were cultured in 16% of cases, and only anaerobes were cultured in 51% of cases. Mixed growth of aerobes and anaerobes was observed in 21% of cases. The cultured bacteria were mainly aerobic Streptococcus, anaerobic Gram-positive cocci, and anaerobic Gram-negative rods. Phagocytosis of bacteria on Gram staining was observed in 9 cases. The bacteria cultured from these cases were aerobic Streptococcus, anaerobic Gram-positive cocci, and anaerobic Gram-negative rods. The sensitivity of Gram staining for the Gram-positive cocci and Gram-negative rods was 90% and 64%, respectively. The specificity of Gram staining for the Gram-positive cocci and Gram-negative rods was 62% and 76%, respectively. Most of the Gram-positive cocci were sensitive to penicillin, but some of anaerobic Gram-negative rods were resistant to penicillin. Conclusion. When Gram staining shows only Gram-positive cocci, penicillin is the treatment of choice. In other cases, antibiotics effective for the penicillin-resistant organisms should be used.