Clinical evaluation of intravenous ampicillin as empirical antimicrobial treatment of acute epiglottitis

Abstract

Introduction: The significant pathogens in acute epiglottitis (AE) are poorly defined in the post Haemophilus influenza type b-vaccine era. Furthermore, there is a lack of clinical evaluations of antibiotic regimens in patients with AE. We aimed to evaluate the effectiveness of empiric intravenous ampicillin in the treatment of patients with AE.

Materials & methods: All patients admitted with AE to the Ear-Nose-Throat Department, Aarhus University Hospital, Denmark, from 2001 to 2015 were included.

Results: In total, 103 (51 males) patients were included in the study. The median duration of hospitalization was four days. There was no statistical significant difference between patients initially treated with intravenous ampicillin (n = 83) or other antibiotics (n = 20) (p = .26). The antibiotic regimen was altered during admission in 11% of patients, without significant difference between antibiotic groups (ampicillin 10% vs non-ampicillin 15%, p = .44). Complications potentially related to insufficient antibiotic treatment were observed in four (5%) patients initially treated with ampicillin, but in none of the patients initially treated with antibiotics other than ampicillin (p = 1.00). Throat swab cultures and blood cultures frequently yielded negative results.

Conclusions: Intravenous ampicillin is efficient as empiric antibiotic therapy for AE patients, leading to a quick recovery and low complication rates.

Chinese abstract

简介：在流感嗜血杆菌b型疫苗时期之后, 急性会厌炎（AE）的重要病原体并不确定。此外, 缺乏对AE患者的抗生素方案的临床评价。我们旨在评估经验性静脉注射氨苄青霉素治疗AE患者的有效性。

材料与方法：2001年至2015年期间, 所有入住丹麦奥胡斯大学医院耳鼻咽喉科的患者均被纳入该研究。

结果：本研究共纳入103例（51例男性）患者。住院时长中位数为4天。最初用静脉注射氨苄青霉素（n = 83）或其它抗生素（n = 20）（p = 0.26）治疗的患者之间无统计学差异。在11％的患者住院期间, 抗生素方案改变, 抗生素群组（氨苄青霉素10％对非氨苄青霉素15％, p = 0.44）之间没有显著性差异。在最初用氨苄青霉素治疗的4例（5％）患者中观察到与抗生素治疗不足有潜在相关性的并发症, 但最初没有使用除氨苄青霉素以外的抗生素治疗的患者（p = 1.00）没有观察到并发症。喉拭培养和血液培养经常产生阴性结果。

结论：静脉注射氨苄青霉素作为AE患者的经验性抗生素治疗是有效的, 导致快速恢复, 并发症发生率较低。

Keywords:

• Acute epiglottitis
• ampicillin
• empiric antibiotics
• treatment
• complications
• bacterial pathogens

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

Lundbeck FoundationThis work was supported by the Lundbeck Foundation [Grant number: R185-2014-2482].