From the Research
Peritonsillar abscess should be treated with empiric antibiotic therapy, preferably with penicillin, and drainage to reduce morbidity and mortality. The condition is a collection of pus between the tonsil and its surrounding tissue, typically requiring prompt treatment with antibiotics and drainage. Initial management includes empiric antibiotic therapy with penicillin (such as amoxicillin-clavulanate 875/125 mg twice daily) or, for penicillin-allergic patients, clindamycin (300-450 mg four times daily) for 10-14 days, as supported by a recent study 1. Drainage is essential and can be performed via:
- Needle aspiration
- Incision and drainage
- Quinsy tonsillectomy in severe or recurrent cases Patients should receive adequate pain control with acetaminophen or NSAIDs, and may need intravenous hydration if they have difficulty swallowing. Hospitalization is recommended for patients with severe symptoms, inability to tolerate oral intake, or those at high risk for airway compromise. The condition results from progression of acute tonsillitis, with bacteria (commonly Group A Streptococcus, Staphylococcus aureus, or anaerobes) spreading beyond the tonsillar capsule. Without proper treatment, complications can include airway obstruction, spread of infection to deep neck spaces, or sepsis. After resolution, patients with recurrent episodes should be evaluated for tonsillectomy to prevent future occurrences, as suggested by various studies 2, 3, 4, 5.