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Is there an association between prior anti-inflammatory drug exposure and occurrence of peritonsillar abscess (PTA)? A national multicenter prospective observational case–control study

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Abstract

The aim of this study was to evaluate whether recent systemic anti-inflammatory agents (AIAs) exposure in patients with sore throat managed with or without antibiotic therapy influenced the risk of peritonsillar abscess (PTA). We conducted a multicenter case–control study in 13 French university hospitals in 2009–2012 comparing patients admitted with PTA to matched controls: patients with sore throat but without PTA who were followed up for 10 days after visiting their primary-care physician. In the multivariate stepwise logistic regression model comparing 120 cases with PTA to 143 controls, factors significantly associated with PTA were male gender (odds ratio [OR], 2.0; p = 0.03), smoking (OR, 2.0; p = 0.03), and prior self-medication with systemic AIAs (OR, 3.5; p = 0.01). Topical treatment was associated with significant protection against PTA (OR, 0.3; p < 0.001). In conclusion, self-medication with systemic AIAs appears to be an independent factor associated with the occurrence of PTA. This is an important message as non-steroidal AIAs access is favored by their over-counter availability in pharmacies. This finding must be interpreted with caution due to the study design and a prospective, randomized study is needed to substantiate these possible causal risk factors.

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Acknowledgments

We thank Line Happi-Djeukou and Olivier Boutin for their contribution to the data collection and for contacting the primary-care physicians who enrolled the controls. We thank Tanguy Roman for his contribution to building the electronic database.

Author contributions

Conceived and designed the study: DL, NA, FB, JC, CF, GP.

Performed the monitoring of the study: DL, VP, NA, CF, CR, GP.

Analyzed the data: DL, CB.

Wrote and validated the final version of the paper: DL, VP, PLC, CB, NA, JC, CF, EB, GP.

Author information

Authors and Affiliations

  1. Bacteriology and Infection Control Department, Nantes University Hospital, 44093, Nantes, France

    D. Lepelletier, C. Bourigault & J. Caillon

  2. Emergency Department, Nantes University Hospital, 44093, Nantes, France

    V. Pinaud, P. Le Conte, E. Batard & G. Potel

  3. Infectious Diseases Department, Nantes University Hospital, 44093, Nantes, France

    N. Asseray

  4. Medqual, Nantes University Hospital, 44093, Nantes, France

    F. Ballereau

  5. Otorhinolaryngology Department, Nantes University Hospital, 44093, Nantes, France

    C. Ferron

  6. Otorhinolaryngology Department, Michallon University Hospital, 38000, Grenoble, France

    C. Righini

  7. Medical School, MiHAR Lab, University of Nantes, EA 3826, 44035, Nantes, France

    D. Lepelletier, N. Asseray, F. Ballereau, J. Caillon, E. Batard & G. Potel

Authors
  1. D. Lepelletier
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  2. V. Pinaud
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  8. C. Ferron
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  9. C. Righini
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  10. E. Batard
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  11. G. Potel
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Consortia

for the French PTA Study Group

  • B. Mazet-Guillaume
  • , L. Lacourreye
  • , M.-L. Joly-Guillou
  • , E. Casalino
  • , B. Barry
  • , A. Andremont
  • , E. Roupie
  • , S. Moreau
  • , R. Leclerq
  • , E. Zuber
  • , J.-F. Vellin
  • , R. Bonnet
  • , C. Paquier
  • , C. Righini
  • , J. Croize
  • , D. Garrigue
  • , X. Pasquesoone
  • , D. Izard
  • , G. Potel
  • , P. Bordure
  • , P. Bemer
  • , C. Ginsburg
  • , P. Corlieu
  • , C. Poyart
  • , P. Plaisance
  • , P. Herman
  • , L. Raskine
  • , M. Scepi
  • , X. Dufour
  • , C. Burucoa
  • , J. Bouget
  • , F. Jegoux
  • , M. Cormier
  • , D. Lauque
  • , E. Serrano
  • , G. Chabanon
  • , R. Lanotte
  • , E. Lescanne
  •  &  Holstein

Corresponding author

Correspondence to D. Lepelletier.

Ethics declarations

Ethical statement

We declare that compliance with ethical standards was followed during the study period.

Funding

No specific funding has been received.

Conflict of interest

The authors have declared that no potential conflict of interest exists.

Ethical approval

Approval was obtained from the Ethic Committee of the Nantes Clinical Research Directory.

Informed consent

Written informed consent was obtained from each hospitalized patient with peritonsillar abscess.

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Lepelletier, D., Pinaud, V., Le Conte, P. et al. Is there an association between prior anti-inflammatory drug exposure and occurrence of peritonsillar abscess (PTA)? A national multicenter prospective observational case–control study. Eur J Clin Microbiol Infect Dis 36, 57–63 (2017). https://doi.org/10.1007/s10096-016-2770-1

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  • DOI: https://doi.org/10.1007/s10096-016-2770-1

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