Peritonsillar Abscess

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CLINICAL FEATURESSIGNS 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 therapeutic effect