Corticosteroids useful for treating both retropharyngeal and parapharyngeal abscess in kids: Study

Treatment of retropharyngeal abscesses (RPAs) and parapharyngeal abscesses (PPAs) includes antibiotics, with possible surgical drainage. Although corticosteroids may decrease inflammation, their role in the management of retropharyngeal abscesses (RPAs) and parapharyngeal abscesses (PPAs) is unclear. The researchers evaluated the association of corticosteroid administration as part of initial medical management on drainage rates and length of stay for children admitted with retropharyngeal abscesses (RPAs) and parapharyngeal abscesses (PPAs)

The researchers conducted a retrospective study using administrative data of children aged 2 months to 8 years discharged with retropharyngeal abscesses (RPAs) and parapharyngeal abscesses (PPAs) from 2016 to 2019. Exposure was defined as systemic corticosteroids administered as part of initial management. Primary outcome was surgical drainage. Bivariate comparisons were made between patients in the corticosteroid and non-corticosteroid groups by using Wilcoxon rank or χ2 tests. Outcomes were modelled by using generalized linear mixed-effects models.

The results of the study are as follows:

• Of the 2259 patients with retropharyngeal abscesses (RPAs) and parapharyngeal abscesses (PPAs), 1677 (74.2%) were in the non-corticosteroid group and 582 (25.8%) were in the corticosteroid group.
• There were no significant differences in age, sex, or insurance status.
• There was a lower rate of drainage in the corticosteroid cohort (odds ratio: 0.28; confidence interval: 0.22–0.36).
• Patients in this group were more likely to have repeat computed tomography imaging performed, had lower hospital costs, and were less likely to have opioid medications administered.
• The corticosteroid cohort had a higher 7-day emergency department revisit rate, but there was no difference in length of stay (rate ratio 0.97; confidence interval: 0.92–1.02).

Thus, the researchers concluded that corticosteroids were associated with lower odds of surgical drainage among children with retropharyngeal abscesses (RPAs) and parapharyngeal abscesses (PPAs).

Reference:

Corticosteroids in the Treatment of Pediatric Retropharyngeal and Parapharyngeal Abscesses by Pratichi K. Goenka et al. published in the American Academy of Pediatrics.

DOI: https://doi.org/10.1542/peds.2020-037010