Peritonsillar Abscess

Signs and Symptoms

• May cause difficulty in swallowing
• Fever
• Tenderness at the angle of the jaw
• Features of upper airway obstruction such as difficulties in breathing, stridor
• Patient is unable to drink at all

Treatment

Adults

• Give Amoxycillin 500mg 8 hourly and Metronidazole 400mg 8 hourly

Alternatively

• Give Benzylpenicillin 2 MU IV 6 hourly
• Switch when possible (usually after 48-72 hours) to oral

Amoxycillin 500mg 8 hourly

• Continue for a total of 14 days antibiotic treatment

Alternatively, if penicillin hypersensitivity:

• Give Erythromycin 500mg 6 hourly

Children

• Give Benzylpenicillin 50,000units/kg/dose 6 hourly
• Switch when possible (usually after 48-72 hours) to oral Amoxycillin 15mg/kg 8 hourly
• Continue for a total of 14 days antibiotic treatment

Alternatively, if penicillin hypersensitivity:

• Give Erythromycin 10 mg/kg/dose 6 hourly

Further treatment

• Give analgesic/antipyretic for pain and fever
• Refer to hospital for the following
• If pus is present and does not drain spontaneously then carry out incision and drainage
• If quinsy is present carry out needle aspiration for analgesic and therapeuticeffect