Analysis of life-threatening complications of deep neck abscess and the impact of empiric antibiotics

Background: To review our experience in the treatment of deep neck abscesses, including analysis of the contributing factors related to the life-threatening complications and the effects of empiric antibiotics on the outcomes. Methods: A retrospective study and statistical analysis of patients with deep neck abscesses treated at Chang Gung Memorial Hospital between April 2000 and April 2006. Results: A total of 105 patients were enrolled in this study, including 66 males and 39 females with age ranging from 18 to 93 years. The result of logistic regression showed that old age, patients with underlying systemic diseases (p<0.05) and ineffective empiric antibiotics (p<0.01) had statistically significant correlation with life-threatening complications. When the age was older than 65 years, the empiric antibiotics were not effective, the way of drainage of the abscess was transcervical incision, the initial deep neck abscess involved more than 1 space, or the patient had underlying systemic diseases or complications, the duration of hospital stay tended to be longer (p <0.01). Conclusions: Even when adequately draining the abscess, the treatment of deep neck abscess in old-age patients more than 65 years, or the patients with ineffective empiric antibiotics or underlying systemic diseases should be more aggressive because life-threatening complications happen more frequently.