Out-patient management of patients with a peritonsillar abscess

In the United Kingdom, patients with a peritonsillar abscess are usually managed as inpatients. However, studies in other countries have shown successful management of these patients as outpatients. We designed an evidence based protocol for the management of patients with a peritonsillar abscess. Diagnosis was by aspiration of pus. Initial treatment was with analgesia, 1.2 g co-amoxiclav and 4 mg dexamethasone intravenously. Data were collected prospectively over 11 months on the management of all patients who had been confirmed by aspiration of pus to have a peritonsillar abscess. Four of the 46 patients (9%) treated as per the protocol required admission, two immediately and two later on. Of the 44 patients initially treated as outpatients, 41 said they were happy to have been treated as outpatients and not admitted to hospital (93%). Patients with a peritonsillar abscess can be managed successfully as outpatients with a high degree of patient satisfaction.