Quinsy / peritonsillar abscess

Case Definition:

Usually resulting as a complication of acute tonsillitis/pharyngitis with abscess formation between the tonsil and lateral pharyngeal wall. Normally unilateral, rarely bilateral.

 

Diagnostic criteria:

The affected tonsil is pushed medially towards or even across the mid line. Pain can be severe, associated with otalgia, trismus, dysphagia and drooling of saliva. Patient usually pyrexial and systemically unwell.

 

Specimens to be collected:

  • Throat swab for bacterial culture
  • Monospot test (serum) if appropriate
Severity
(classification)

1st line oral/iv antibiotics

Penicillin allergy
(see explanatory notes)
A/B/C

Minor to severe life threatening infection 

Review doses in renal impairment

BENZYLYPENICILLIN 1.2g iv qds

 plus

METRONIDAZOLE 500mg iv tds

Typical total duration: 7 days
For group A streptococcus, typically 10 days.

 

CLINDAMYCIN 1.2g iv qds 

 

Typical total duration: 7 days
For group A streptococcus, typically 10 days.

IV to Oral Switch (explanatory notes

CO-AMOXICLAV 625mg po tds

Typical total duration: 7 days
For group A streptococcus, typically 10 days.

CLINDAMYCIN 450mg po qds

Typical total duration: 7 days
For group A streptococcus, typically 10 days.

Last reviewed:23/04/14

For guidance on the administration of intravenous antibiotics
click here (GHNHSFT intranet only)