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Microbiological analysis and antibiotic selection strategy in neck abscesses among patients with diabetes mellitus

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Abstract

Purpose

This study aimed to analyze the clinical characteristics, pathogen distribution, drug sensitivity, and antibiotic treatment strategies of patients with neck abscesses with or without diabetes.

Methods

A retrospective analysis was conducted on 2194 patients who underwent neck abscess surgery at our hospital over the past 13 years. Patients were grouped as NAwithDM (neck abscess with diabetes mellitus) or NAwithoutDM (neck abscess without diabetes mellitus). Clinical features, pathogen distribution, and antibiotic sensitivity were compared between the groups. Venn diagrams were used to illustrate the antibiotics effective against all three predominant pathogens.

Results

A total of 2194 patients with neck abscesses were included in this study, with 579 patients (26.43%) in the NAwithDM group and 1612 patients (73.51%) in the NAwithoutDM group. There were no significant differences in sex or age distribution between the two groups (all P > 0.05). However, there were significant differences in BMI, length of hospital stays, occurrence of laryngeal obstruction, hypertension, and hypoalbuminemia between the two groups (all P < 0.05). In the NAwithoutDM group, the top three pathogens were Streptococcus constellatus, Klebsiella pneumoniae, and Staphylococcus aureus. The antibiotics that were simultaneously effective against all three pathogens were ceftriaxone, moxifloxacin, and ampicillin/sulbactam. In the NAwithDM group, the top three pathogens were Streptococcus pyogenes, Streptococcus pneumoniae, and Streptococcus constellatus. The antibiotics that were simultaneously effective against all three pathogens were compound sulfamethoxazole, cefuroxime, levofloxacin, ciprofloxacin, vancomycin, and imipenem.

Conclusion

Neck abscess patients with diabetes have distinct clinical features. Therefore, it is crucial to pay attention to these clinical features and manage them accordingly during the treatment process. Empirical antibiotic treatment should be tailored to individual patient groups. Sulfamethoxazole-methoxazole is recommended for neck abscess patients with diabetes, while ceftriaxone or moxifloxacin is recommended for those without diabetes.

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Data availability

Relevant data can be obtained by contacting the first author.

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Acknowledgements

Hai Li and Hailing Gu for their critical advises on the publication.

Funding

No funding was received for this study.

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Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China

    Weili Kong, Xiaoyun Zhang, Mei Li & Hui Yang

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  1. Weili Kong
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  2. Xiaoyun Zhang
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  3. Mei Li
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  4. Hui Yang
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Correspondence to Hui Yang.

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Kong, W., Zhang, X., Li, M. et al. Microbiological analysis and antibiotic selection strategy in neck abscesses among patients with diabetes mellitus. Eur Arch Otorhinolaryngol 281, 1515–1523 (2024). https://doi.org/10.1007/s00405-023-08396-w

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