From the Research
The treatment for a tonsillar abscess typically involves drainage of the abscess along with antibiotic therapy, with the most recent and highest quality study suggesting that needle aspiration and antibiotic therapy can be an effective treatment approach 1. The primary approach is incision and drainage performed by an otolaryngologist (ENT specialist) or emergency physician, which provides immediate relief by removing the collected pus. This is usually done under local anesthesia in adults or general anesthesia in children. Following drainage, antibiotics are prescribed to eliminate the remaining infection.
- Common antibiotic regimens include amoxicillin-clavulanate (875/125 mg twice daily for 10-14 days), clindamycin (300-450 mg four times daily for 10 days) for penicillin-allergic patients, or a combination of a penicillin with metronidazole to cover anaerobic bacteria, as supported by studies such as 2 and 3.
- Pain management with acetaminophen or ibuprofen is important during recovery.
- Patients should maintain hydration, use warm salt water gargles, and consume soft foods until symptoms improve. In severe cases with airway compromise, hospitalization may be necessary. Prompt treatment is essential as tonsillar abscesses can lead to serious complications including airway obstruction, spread of infection to adjacent tissues, or sepsis if left untreated, highlighting the importance of early intervention as noted in studies such as 4 and 5.