573 The Changing Microbiology of Paediatric Neck Abscesses: Implications for Antibiotic Therapy

Abstract

Abstract Aim To provide an update on the microbiology, sensitivity rates and antibiotic prescribing patterns of drained superficial neck lymph node abscesses at Scotland's largest paediatric tertiary centre. Findings were compared to historical data from our institution. Analysis of the microbiology and epidemiological trends of paediatric neck abscesses is helpful for both antimicrobial stewardship purposes as well as to enhance the literature, given that paediatric-related conditions tend to be less well characterised when compared with adults. Method A retrospective case series of paediatric patients undergoing incision and drainage of a superficial neck lymph node abscess at the Royal Hospital for Children in Glasgow, 2018–2021. Patients were only included if they had culture and sensitivity testing performed on a sample obtained intra-operatively, were prescribed antibiotics, and were aged 16 years or younger. Results Thirty-nine abscesses were identified. Methicillin-susceptible Staphylococcus aureus remains the commonest organism (28%), followed by Streptococcus pyogenes (13%). Their prevalence is significantly lower in comparison to historical data. This was met by a shift towards a variety of rarer micro-organisms. 82% of patients were administered a drug regimen containing co-amoxiclav. Only 3 children required a change in their antibiotics. Conclusion Our case series highlights a fall in the yearly rate of drained neck abscesses. There was a significant change in causative micro-organisms, including a decrease in Staphylococcus aureus and an increase in the Streptococcus anginosus group. We recommend the use of co-amoxiclav empirically. In abscesses showing no clinical improvement, second-line options such as clindamycin, cefotaxime and vancomycin should be considered.