From the Research
Treating quinsy with steroids and antibiotics alone, without surgical drainage, is generally not recommended for most cases, as the standard treatment typically involves drainage of the abscess along with antibiotics. The most recent and highest quality study, 1, published in 2022, emphasizes the importance of incision and drainage for abscesses, stating that most simple abscesses can be diagnosed and managed in the ambulatory office with incision and drainage. While steroids may help reduce inflammation and pain, they are typically used as an adjunct to drainage, not as a replacement. Without drainage, the abscess can worsen, leading to complications such as airway obstruction, spread of infection to nearby tissues, or even sepsis.
Some key points to consider when treating quinsy include:
- The use of antibiotics, such as penicillin, amoxicillin-clavulanate, or clindamycin for penicillin-allergic patients, to help manage the infection
- The importance of drainage, which can be performed by needle aspiration or incision and drainage, to remove the collection of pus
- The potential benefits of using steroids, like dexamethasone, to reduce inflammation and pain, but only as an adjunct to drainage
- The need for immediate medical attention if quinsy is suspected, as delays in treatment can lead to serious complications
It's also worth noting that some studies, such as 2 and 3, have explored the use of local anaesthetic and oropharyngeal endoscopy as therapeutic adjuncts and training tools in the management of quinsy. However, these studies do not suggest that steroids and antibiotics alone are sufficient for treatment. Instead, they highlight the importance of proper drainage and management of the abscess.
In terms of patient demographics, a study from 4 found that patients with quinsy were more likely to be aged 21-40 years, smokers, and male. However, this study did not provide evidence that antibiotics prevent quinsy, and instead emphasized the importance of prompt medical attention and proper treatment.
Overall, the most effective treatment for quinsy involves drainage of the abscess, along with antibiotics, and potentially steroids as an adjunct to reduce inflammation and pain. If you suspect you have quinsy, it's essential to seek immediate medical attention to determine the best course of treatment.