From the Guidelines
Peritonsillar abscess patients should complete their full course of antibiotics, typically amoxicillin-clavulanate 875/125 mg twice daily or clindamycin 300 mg four times daily for 10-14 days, and follow a comprehensive treatment plan to manage symptoms and prevent complications. After treatment, patients should take pain medications as prescribed, usually acetaminophen or ibuprofen, to manage discomfort 1. It is essential to stay hydrated by drinking plenty of fluids and eat soft, cool foods like yogurt, smoothies, and soups to minimize throat pain. Gargling with warm salt water (1/2 teaspoon salt in 8 ounces of water) several times daily can help reduce inflammation 1. Patients should rest their voice and avoid smoking or alcohol, which can irritate the throat.
Some key points to consider in patient education include:
- Watching for warning signs requiring immediate medical attention: difficulty breathing, increased pain, fever above 101°F, or inability to swallow
- Understanding that most patients improve within 2-3 days of treatment, but complete healing takes 1-2 weeks
- Recognizing that the abscess formed because bacteria from a tonsil infection spread into the surrounding tissue, creating a pocket of infection that required drainage through needle aspiration or incision by a healthcare provider
- Being aware of the importance of completing the full course of antibiotics to prevent recurrence and reduce the risk of complications, as recommended by the 2012 IDSA clinical guidelines 1.
Overall, a comprehensive treatment plan and patient education are crucial to managing peritonsillar abscess and preventing complications, and patients should follow their healthcare provider's instructions carefully to ensure the best possible outcome.
From the Research
Patient Education for Peritonsillar Abscess
Peritonsillar abscess is a serious condition that requires prompt medical attention. The following information can help patients understand their condition and treatment options:
- Definition and Symptoms: A peritonsillar abscess is a collection of pus behind the tonsils, typically caused by a combination of aerobic and anaerobic bacteria 2. Symptoms include fever, throat pain, and trismus.
- Diagnosis and Treatment: Diagnosis is typically made through ultrasonography, computed tomographic scanning, or needle aspiration 2. Treatment usually involves antibiotic therapy, such as penicillin, clindamycin, cephalosporins, or metronidazole, and may require incision and drainage or immediate tonsillectomy in advanced cases 2, 3.
- Outpatient Management: Studies have shown that patients with peritonsillar abscess can be successfully managed as outpatients with a high degree of patient satisfaction 4, 5. Outpatient treatment typically involves analgesia, antibiotics, and dexamethasone.
- Antibiotic Choice: The choice of antibiotic therapy is important, with amoxicillin-clavulanic acid being suggested as a first-line treatment for patients with unilateral peritonsillar swelling and trismus 3. Clindamycin has also been shown to be effective in treating peritonsillar abscess on an outpatient basis 5.
- Treatment in Children: In children, the mainstay of treatment is antibiotic therapy with incision and drainage of the abscess, although alternatives such as antibiotic treatment alone or in association with needle aspiration may be considered 6. Immediate tonsillectomy is typically reserved for high-risk patients.