“Clinico-Microbiological Study of Tonsillitis for Bacterial Flora and its Resistance Pattern”

Background- This study was conducted to identify the prevalence of bacterial pathogens and their antibiotic sensitivity that would indicate the optimum line of treatment and prevent the complications of acute and chronic tonsillitis avoiding unnecessary surgical treatment. Methodology-This study was conducted as a facility based observational prospective study on patients with acute or chronic tonsillitis presenting at Department of ENT, People’s Hospital. Detailed history and oral examination was done and swab was obtained for culture sensitivity. Results-A total of 236 cases with tonsillitis were enrolled in our study, of them, 111(47%) cases had acute tonsillitis whereas 125(53%) cases had chronic tonsillitis with mean duration of 15.2±5.5 days and 1.1±0.4 years respectively. Bacteriological prevalence was 48.7%. Most common microorganism was group A beta haemolytic streptococci(27.1%), followed by Staphylococcus aureus(11%). Group A beta haemolytic streptococci were resistant to cefepime, gentamycin and doxycycline in 81.2% cases and 84.4% cases of acute and chronic tonsillitis respectively. In 100% cases, we found levofloxacin to be resistant for staphylococcus aureus. Pseudomonas aeruginosa were resistant to Gentamycin, Gemifloxacin and Nitrofurantoin in 100% cases of acute tonsillitis. However, in cases with chronic tonsillitis, Gentamycin, Gemifloxacin and Nitrofurantoin were resistant against pseudomonas in 81.2% cases. Conclusions- Bacteriological prevalence can be documented in as high as half of the cases with acute and chronic tonsillitis and different pathogenic microbes are resistant to different antibiotics. In culture negative cases with no underlying bacterial pathology, antibiotics prescription is not necessary. Thus, it is necessary to perform swab culture and antibiotic sensitivity to avoid irrational use of antibiotics and to prescribe antibiotics based upon the underlying pathogenic microorganism and drug susceptibility