Assessment of Change in Microbiology and Antibiotic Sensitivity of Deep Neck Infection Over 10 Years

Abstract

Background and Objectives Treatment using systemic antibiotic administration and surgical drainage has been the common treatment modality for deep neck infection. This study compared the changing pattern of isolated pathogens to recommend the best empirical antibiotics for deep neck infection.Subjects and Method Reviewed retrospectively were medical charts of 131 patients who, confirmed with deep neck infection, underwent surgical drainage for pus cultures at Ewha Womans University Medical Center between January, 2009 and July, 2019. We analyzed the changing pattern of isolated pathogens and antibiotic susceptibility tests using their pus cultures.Results <i>Streptococcus viridans</i> was the most commonly isolated organism (35.1%), followed by <i>Klebsiella pneumonia</i> (13.7%) and <i>Staphylococcus aureus</i> (4.6%). The isolation rate of <i>Streptococcus viridans</i> increased in the recent 10 years [<i>p</i>=0.016, odds ratio (OR)=3.417]. Antibiotic susceptibility tests showed that all pathogens were resistant to ampicillin, but susceptible to ampicillin/sulbactam and cephalosporin. The isolation rate of clindamycin resistant pathogens was increased with statistical significance (<i>p</i>=0.020, OR=8.076).Conclusion Antibiotics effective against both <i>Streptococcus viridans</i> and <i>Klebsiella pneumonia</i> should be used as the first-line of treatment for deep neck infection. Ampicillin/sulbactam or amoxicillin/clavulanic acid were sufficient to treat deep neck infection empirically regardless of age or underlying diseases.