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Management of peritonsillar abscess.

D Maharaj1, V Rajah, S Hemsley

  • 1University of Natal, Faculty of Medicine, Department of Otorhinolaryngology, Congella, South Africa.

The Journal of Laryngology and Otology
|September 1, 1991
PubMed
Summary

Permucosal needle aspiration is a safe and effective outpatient treatment for peritonsillar abscess, comparable to incision and drainage. Most patients can avoid hospitalization and intravenous antibiotics, responding well to oral penicillin.

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Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Surgical Procedures

Background:

  • Peritonsillar abscess (PTA) is a common complication of tonsillitis.
  • Traditional management often involves incision and drainage (I&D) and hospital admission.
  • Optimal management strategies require further investigation.

Purpose of the Study:

  • To compare the safety and efficacy of permucosal needle aspiration (PNA) versus I&D for PTA.
  • To evaluate the necessity of hospital admission and intravenous antibiotics for PTA.
  • To guide antibiotic therapy based on microbial cultures of abscess pus.

Main Methods:

  • A prospective, randomized clinical trial involving 60 patients with confirmed PTA.
  • Patients were randomized into two groups: PNA (30 patients) and I&D (30 patients).

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  • Pus cultures were obtained, and treatment outcomes, including hospital admission rates, were recorded.

    • Main Results:

    • Initial success rates were high for both PNA (87%) and I&D (90%).
    • Only two patients required hospital admission for supportive care.
    • Streptococci were the most common pathogens (62%), with 97% of patients responding to penicillin.

    Conclusions:

    • Permucosal needle aspiration is a safe and effective alternative to incision and drainage for PTA.
    • Most patients with PTA can be managed successfully on an outpatient basis with oral antibiotics.
    • Rational antibiotic selection, often penicillin, is effective based on common microbial findings.