Abstract
Deep neck abscesses and phlegmons remain a significant clinical challenge due to their aggressive course, polymicrobial etiology, and potential progression toward life-threatening complications such as descending mediastinitis and sepsis. Contemporary management relies on the timely integration of clinical assessment, imaging, surgical decision-making, and, crucially, appropriate antibiotic therapy. This abstract reviews the current relevance of antibiotic treatment in deep neck infections, structured according to a standardized, data-driven framework inspired by encyclopedic bioanalytical models.
Clinical evidence was derived from a retrospective case series including seven patients with cervical abscesses or phlegmons, observed over four years. The most frequent primary sources of infection were odontogenic and tonsillar, consistent with the known polymicrobial flora of the upper aerodigestive tract. Empiric broad-spectrum intravenous antibiotic therapy was initiated promptly in all cases, targeting both aerobic and anaerobic pathogens. Microbiological cultures from selected patients identified organisms such as Propionibacterium, Bacteroides, and Klebsiella, supporting the need for regimens with extended antimicrobial coverage. Despite literature-reported mortality rates for descending mediastinitis ranging from 30% to over 50%, and up to 75% in complicated cases, all patients in the series survived, including those with mediastinal involvement.
These data underscore the central role of early empiric antibiotic therapy, subsequently refined by culture and sensitivity testing, in determining favorable outcomes. Similar to structured pharmacological databases used in bioavailability and bioequivalence research, a systematic approach to antibiotic selection, based on pathogen spectrum, tissue penetration, and clinical severity, enhances therapeutic precision. In modern clinical practice, antibiotic therapy remains a decisive factor in reducing morbidity and mortality in deep neck infections when integrated within a multidisciplinary management strategy.
