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AuthorWiksten, Johanna E.
AuthorPitkaranta, Anne
AuthorBlomgren, Karin
Available date2021-09-01T10:03:27Z
Publication Date2016
Publication NameJournal of Antimicrobial Chemotherapy
ResourceScopus
URIhttp://dx.doi.org/10.1093/jac/dkw038
URIhttp://hdl.handle.net/10576/22453
AbstractObjectives The objectives of this study were to evaluate the efficacy of metronidazole in conjunction with penicillin in preventing the recurrence of peritonsillar abscess (PTA) and to learn whether metronidazole enhances the recovery from PTA when compared with penicillin alone. Methods In this prospective, double-blind, randomized, placebo-controlled trial, 200 adult outpatients with PTA at our ear, nose and throat emergency department received either penicillin (1 000 000IU) × 3 and metronidazole (400 mg) × 3 for 10 and 7 days orally (combination group, N = 100) or penicillin and placebo (penicillin group, N = 100) after incision and drainage of the PTA. Afterwards they received a symptom questionnaire via e-mail daily for 2 weeks, then weekly for 6 weeks. The primary outcome was efficacy of metronidazole in conjunction with penicillin in preventing PTA recurrence in 56 days; the secondary outcome was ability of metronidazole plus penicillin to enhance recovery from PTA in 28 days. All healthcare contacts were registered during follow-up. Registered on www.clinicaltrials.gov with the identifier NCT01255670. Results Of the 200 patients, 20 returned to hospital with recurrent symptoms, 10 in each group (P = 1.00). In the combination group, the mean (SD) duration of throat-related symptoms was 5.6 (5.0) days and in the penicillin group it was 5.3 (2.7) days, values for fever were 1.5 (0.9) and 1.6 (1.0) days, respectively, and those for poor overall physical condition were 4.0 (3.9) and 4.5 (4.9) days; there were no significant differences between groups. The adverse effects nausea and diarrhoea lasted longer in the combination group (P = 0.01). Conclusions For healthy adult PTA patients treated with incision and drainage, metronidazole neither prevents recurrence nor enhances recovery when combined with penicillin compared with penicillin alone, but instead leads to increased adverse effects.
Languageen
PublisherOxford University Press
Subjectmetronidazole
penicillin derivative
placebo
antiinfective agent
metronidazole
penicillin derivative
adult
aged
Article
controlled study
convalescence
diarrhea
dizziness
double blind procedure
drug efficacy
e-mail
female
fever
follow up
headache
human
major clinical study
male
nausea
outcome assessment
peritonsillar abscess
prospective study
questionnaire
randomized controlled trial
rash
recurrent disease
symptom
treatment duration
treatment outcome
adolescent
clinical trial
combination drug therapy
comparative study
Drainage
microbiology
middle aged
peritonsillar abscess
procedures
secondary prevention
very elderly
young adult
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents
Double-Blind Method
Drainage
Drug Therapy, Combination
Female
Humans
Male
Metronidazole
Middle Aged
Penicillins
Peritonsillar Abscess
Recurrence
Secondary Prevention
Surveys and Questionnaires
Treatment Outcome
Young Adult
TitleMetronidazole in conjunction with penicillin neither prevents recurrence nor enhances recovery from peritonsillar abscess when compared with penicillin alone: A prospective, double-blind, randomized, placebo-controlled trial
TypeArticle
Pagination1681-1687
Issue Number6
Volume Number71
dc.accessType Abstract Only


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