Quinsy - Peritonsillar Abscess

What are the treatments for the infection?

If caught early, a peritonsillar abscess usually responds to antibiotics. These include erythromycin, penicillin, metronidazole, and nafcillin. Oral corticosteroids, such as methylprednisolone or prednisone, may be used. Steroids are used with care because they can mask the spread of the infection.

Once it has reached the abscess stage, the infection can be managed in several ways. Some people respond to oral antibiotics, pain medications, and repeated draining of the abscess with a needle.

The most time-honored treatment is to open the abscess and drain it. This is usually done in a healthcare provider's office, but it sometimes needs to be done in an operating room.

If the person does go to surgery, the tonsils are usually removed. Most people with a first occurrence of the abscess just have it drained. A person with a history of chronic or recurrent tonsillitis may need a tonsillectomy. The tonsillectomy can be done immediately or a few weeks after draining the abscess.

What are the side effects of the treatments?

Antibiotics can cause stomach upset, rash, and allergic reactions. Corticosteroids can cause sleeplessness and increased risk of infection.

If the abscess is drained with a needle, there are very few side effects. Usually the person feels much better as soon as it is drained. Opening the abscess with a knife also has very few side effects. There may be some temporary bleeding.

If the tonsils are removed, excess bleeding occurs about 3% of the time. Draining the abscess usually stops the pain very quickly. Surgery carries a risk of bleeding, infection, and allergic reaction to anesthesia.

What happens after treatment for the infection?

If treatment is successful, the symptoms improve rapidly. The person soon returns to a healthy state. The healthcare provider may recommend a tonsillectomy to prevent future peritonsillar abscesses.

How is the infection monitored?

Peritonsillar abscesses recur in 10% to 15% of the individuals. Any new or worsening symptoms should be reported to the healthcare provider.