1337. Stewardship Opportunities for Cervical Lymphadenitis and Deep Neck Space Infections

Abstract Background Cervical lymphadenitis (LAD) and deep neck space abscesses (DNSA) are common pediatric infections caused by similar bacteria. We sought to determine differences in presentation, diagnosis, treatment between LAD DNSA identify antimicrobial diagnostic stewardship opportunities. Methods Charts were obtained using ICD9/10 codes for retropharyngeal parapharyngeal abscessed (DNSA), 1/1/10-12/31/20 from two centers. 1981 charts identified. excluded if the diagnosis was not a bacterial infection (e.g. Kawasaki disease), neck, or less bacteria tuberculosis). Data on presenting signs, symptoms, imaging, microbiology results, antibiotics, surgical interventions collected. Statistical analyses groups performed with Fisher’s exact Wilcoxon rank-sum tests. Results 1432 patients met inclusion criteria; 767 LAD, 665 DNSA. Median age gender differed DNSA, but no difference seen race (Table). Presenting symptoms different (p < 0.0001) (Figure). Almost all group received CT scan, compared 69% group. Only 8% had an ultrasound, contrast 50% Most both blood culture obtained; these negative ≥ 95% of cases. Abscess cultures more commonly grew S. aureus, while pyogenes Clindamycin most antibiotic utilized; 91% 87% 2 antibiotics; 81% 63% Conclusion These data may be used help target LAD. Ultrasound alone sufficient some cases reserved when suspected based signs symptoms. Routine appear unnecessary patients. Multiple antibiotics treat single appropriate, given prevalence Gram positive organisms that would likely respond clindamycin. Disclosures Brian R. Lee, PhD, MPH, CDC: Grant/Research Support|Merck: Support.