From the Research
The treatment of choice for peritonsillar cellulitis is empiric antibiotic therapy targeting the common causative organisms, primarily Group A Streptococcus and anaerobes. The recommended regimen is amoxicillin-clavulanate 875/125 mg orally twice daily for 10-14 days, as supported by the most recent and highest quality studies, such as 1. Alternatives for penicillin-allergic patients include clindamycin 300-450 mg orally four times daily or a combination of a respiratory fluoroquinolone (such as levofloxacin 500 mg daily) plus metronidazole 500 mg three times daily. Unlike peritonsillar abscess, which often requires drainage, peritonsillar cellulitis can typically be managed with antibiotics alone, as noted in 2 and 3. Patients should also be advised to:
- Maintain adequate hydration
- Use analgesics such as acetaminophen or ibuprofen for pain relief
- Gargle with warm salt water to reduce inflammation Close follow-up within 24-48 hours is essential to ensure the infection is responding to treatment and not progressing to abscess formation, as emphasized in 4 and 5. If symptoms worsen despite appropriate antibiotic therapy, reassessment is necessary to rule out abscess development, which would require drainage. It is worth noting that while the provided studies offer valuable insights, the most recent and highest quality study 1 provides the most relevant guidance for the treatment of peritonsillar cellulitis.