Peritonsillar abscess - Revision history

Danbot: Add MedicationDose SMW entries for dexamethasone and methylprednisolone; doses verified against ENT/EM guidelines

2026-03-20T17:43:45Z

Add MedicationDose SMW entries for dexamethasone and methylprednisolone; doses verified against ENT/EM guidelines

← Older revision		Revision as of 17:43, 20 March 2026
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	*Recurrent severe [[pharyngitis]] or PTA		*Recurrent severe [[pharyngitis]] or PTA
	*Failure of [[abscess]] resolution with drainage		*Failure of [[abscess]] resolution with drainage


			==Medication Dosing==
			*{{MedicationDose\|drug=Dexamethasone\|dose=10 mg\|route=IV/PO/IM\|context=Adjunct steroid (pain/inflammation)\|indication=Peritonsillar abscess\|population=Adult\|notes=Decreases duration and severity of pain}}
			*{{MedicationDose\|drug=Methylprednisolone\|dose=125 mg\|route=IV\|context=Adjunct steroid (pain/inflammation)\|indication=Peritonsillar abscess\|population=Adult\|notes=Alternative to dexamethasone}}

	==See Also==		==See Also==

Rossdonaldson1: /* Antibiotics Alone */

2025-04-16T16:48:44Z

Antibiotics Alone

← Older revision		Revision as of 16:48, 16 April 2025
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	====Antibiotics Alone====		====Antibiotics Alone====
	''Caution: No prospective, controlled studies are currently available to support this approach. The most recent ~~Systematic Review and Meta Analysis~~ (2020) found only low-quality data<ref>~~12.~~ Medical Intervention Alone vs Surgical Drainage for Treatment of Peritonsillar Abscess: A Systematic Review and Meta-analysis. Forner D., et al, Otolaryngology–Head and Neck Surgery 2020, Vol. 163(5) 915–922</ref>''		''Caution: No prospective, controlled studies are currently available to support this approach. The most recent review with meta analysis (2020) found only low-quality data.<ref>Medical Intervention Alone vs Surgical Drainage for Treatment of Peritonsillar Abscess: A Systematic Review and Meta-analysis. Forner D., et al, Otolaryngology–Head and Neck Surgery 2020, Vol. 163(5) 915–922</ref>''
	*The medications below and ED observation for 1-2 hours after, with liquid PO challenge:		*The medications below and ED observation for 1-2 hours after, with liquid PO challenge:
	**D5-1/2 NS, 1 L bolus		**D5-1/2 NS, 1 L bolus

Rossdonaldson1: /* Antibiotics Alone */

2025-04-16T16:47:18Z

Antibiotics Alone

← Older revision		Revision as of 16:47, 16 April 2025
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	====Antibiotics Alone====		====Antibiotics Alone====
	''Caution: No prospective, controlled studies are currently available to support this approach ~~as of 2020~~. Systematic Review and Meta Analysis ~~was attempted in~~ 2020 ~~which included the other citations from this post and~~ found only low-quality data<ref>12. Medical Intervention Alone vs Surgical Drainage for Treatment of Peritonsillar Abscess: A Systematic Review and Meta-analysis. Forner D., et al, Otolaryngology–Head and Neck Surgery 2020, Vol. 163(5) 915–922</ref>''		''Caution: No prospective, controlled studies are currently available to support this approach. The most recent Systematic Review and Meta Analysis (2020) found only low-quality data<ref>12. Medical Intervention Alone vs Surgical Drainage for Treatment of Peritonsillar Abscess: A Systematic Review and Meta-analysis. Forner D., et al, Otolaryngology–Head and Neck Surgery 2020, Vol. 163(5) 915–922</ref>''
	*The medications below and ED observation for 1-2 hours after, with liquid PO challenge:		*The medications below and ED observation for 1-2 hours after, with liquid PO challenge:
	**D5-1/2 NS, 1 L bolus		**D5-1/2 NS, 1 L bolus

Rossdonaldson1: /* Antibiotics Alone */

2025-04-16T16:46:09Z

Antibiotics Alone

← Older revision		Revision as of 16:46, 16 April 2025
Line 77:		Line 77:

	====Antibiotics Alone====		====Antibiotics Alone====
			''Caution: No prospective, controlled studies are currently available to support this approach as of 2020. Systematic Review and Meta Analysis was attempted in 2020 which included the other citations from this post and found only low-quality data<ref>12. Medical Intervention Alone vs Surgical Drainage for Treatment of Peritonsillar Abscess: A Systematic Review and Meta-analysis. Forner D., et al, Otolaryngology–Head and Neck Surgery 2020, Vol. 163(5) 915–922</ref>''
	*The medications below and ED observation for 1-2 hours after, with liquid PO challenge:		*The medications below and ED observation for 1-2 hours after, with liquid PO challenge:
	**D5-1/2 NS, 1 L bolus		**D5-1/2 NS, 1 L bolus
Line 84:		Line 85:
	**Upon discharge, [[Clindamycin]] 300 mg PO QID x10-14 days vs [[Amoxicillin/Clavulanate]] 875mg PO BID x10-14 days		**Upon discharge, [[Clindamycin]] 300 mg PO QID x10-14 days vs [[Amoxicillin/Clavulanate]] 875mg PO BID x10-14 days
	**Pediatric protocol is the same, with weight based dosing		**Pediatric protocol is the same, with weight based dosing
	*Studies
	**Caution: No prospective, controlled studies are currently available to support this approach as of 2020. Systematic Review and Meta Analysis was attempted in 2020 which included the other citations from this post and found only low-quality data (10/12 sources were retrospective chart reviews, 1/12 prospective cohort, 1/12 an abstract for an RCT that was never published.) <ref>12. Medical Intervention Alone vs Surgical Drainage for Treatment of Peritonsillar Abscess: A Systematic Review and Meta-analysis. Forner D., et al, Otolaryngology–Head and Neck Surgery 2020, Vol. 163(5) 915–922</ref>
	**For patients given above and felt better (must improve clinically), similar results can be obtained compared to I&D<ref>Comparison Of Medical Therapy Alone To Medical Therapy With Surgical Treatment Of Peritonsillar Abscess Battaglia, A., et al, Otolaryngol Head Neck Surg 58(2):280, February 2018</ref>
	**For patients with smaller abscess sizes or less severe symptoms, medical management leads to similar lengths of hospital stay or complications compared to I&D for larger PTAs<Ref>Souza, D. L., Cabrera, D., Gilani, W. I., Campbell, R. L., Carlson, M. L., Lohse, C. M., & Bellolio, M. F. (2016). Comparison of medical versus surgical management of peritonsillar abscess: A retrospective observational study. The Laryngoscope, 126(7), 1529–1534. https://doi.org/10.1002/lary.25960</ref>
	**For abscesses <2 cm, the treatment-failure rate is 5% for antibiotics alone. <ref> Urban MJ, Masliah J, Heyd C, et al. Ann Otol Rhinol Laryngol. Published online May 12, 2021. https://doi.org/10.1177%2F00034894211015590</ref>

	===[[Antibiotics]]===		===[[Antibiotics]]===

Rossdonaldson1: /* Antibiotics Alone */

2025-04-16T16:44:50Z

Antibiotics Alone

← Older revision		Revision as of 16:44, 16 April 2025
Line 85:		Line 85:
	**Pediatric protocol is the same, with weight based dosing		**Pediatric protocol is the same, with weight based dosing
	*Studies		*Studies
	**Caution: No prospective, controlled studies are currently available to support this approach as of 2020. Systematic Review and Meta Analysis was attempted in 2020 which included the other citations from this post and found only low-quality data (10/12 sources were retrospective chart reviews, 1/12 prospective cohort, 1/12 an abstract for an RCT that was never published.)		**Caution: No prospective, controlled studies are currently available to support this approach as of 2020. Systematic Review and Meta Analysis was attempted in 2020 which included the other citations from this post and found only low-quality data (10/12 sources were retrospective chart reviews, 1/12 prospective cohort, 1/12 an abstract for an RCT that was never published.) <ref>12. Medical Intervention Alone vs Surgical Drainage for Treatment of Peritonsillar Abscess: A Systematic Review and Meta-analysis. Forner D., et al, Otolaryngology–Head and Neck Surgery 2020, Vol. 163(5) 915–922</ref>
	**For patients given above and felt better (must improve clinically), similar results can be obtained compared to I&D<ref>Comparison Of Medical Therapy Alone To Medical Therapy With Surgical Treatment Of Peritonsillar Abscess Battaglia, A., et al, Otolaryngol Head Neck Surg 58(2):280, February 2018</ref>		**For patients given above and felt better (must improve clinically), similar results can be obtained compared to I&D<ref>Comparison Of Medical Therapy Alone To Medical Therapy With Surgical Treatment Of Peritonsillar Abscess Battaglia, A., et al, Otolaryngol Head Neck Surg 58(2):280, February 2018</ref>
	**For patients with smaller abscess sizes or less severe symptoms, medical management leads to similar lengths of hospital stay or complications compared to I&D for larger PTAs<Ref>Souza, D. L., Cabrera, D., Gilani, W. I., Campbell, R. L., Carlson, M. L., Lohse, C. M., & Bellolio, M. F. (2016). Comparison of medical versus surgical management of peritonsillar abscess: A retrospective observational study. The Laryngoscope, 126(7), 1529–1534. https://doi.org/10.1002/lary.25960</ref>		**For patients with smaller abscess sizes or less severe symptoms, medical management leads to similar lengths of hospital stay or complications compared to I&D for larger PTAs<Ref>Souza, D. L., Cabrera, D., Gilani, W. I., Campbell, R. L., Carlson, M. L., Lohse, C. M., & Bellolio, M. F. (2016). Comparison of medical versus surgical management of peritonsillar abscess: A retrospective observational study. The Laryngoscope, 126(7), 1529–1534. https://doi.org/10.1002/lary.25960</ref>

Rossdonaldson1 at 16:44, 16 April 2025

2025-04-16T16:44:07Z

← Older revision		Revision as of 16:44, 16 April 2025
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	[[Category:ID]]		[[Category:ID]]
	[[Category:Procedures]]		[[Category:Procedures]]

	12. Medical Intervention Alone vs Surgical Drainage for Treatment of Peritonsillar Abscess: A Systematic Review and Meta-analysis. Forner D., et al, Otolaryngology–Head and Neck Surgery 2020, Vol. 163(5) 915–922</ref>

Rossdonaldson1: /* External Links */

2025-04-16T16:07:40Z

External Links

← Older revision		Revision as of 16:07, 16 April 2025
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	==External Links==		==External Links==

	~~===Videos===~~
	~~{{#widget:YouTube\|id=I5W27zV-dwI}}~~


	==References==		==References==

Jstowens: /* Antibiotics Alone */

2025-04-01T20:50:31Z

Antibiotics Alone

← Older revision		Revision as of 20:50, 1 April 2025
Line 85:		Line 85:
	**Pediatric protocol is the same, with weight based dosing		**Pediatric protocol is the same, with weight based dosing
	*Studies		*Studies
			**Caution: No prospective, controlled studies are currently available to support this approach as of 2020. Systematic Review and Meta Analysis was attempted in 2020 which included the other citations from this post and found only low-quality data (10/12 sources were retrospective chart reviews, 1/12 prospective cohort, 1/12 an abstract for an RCT that was never published.)
	**For patients given above and felt better (must improve clinically), similar results can be obtained compared to I&D<ref>Comparison Of Medical Therapy Alone To Medical Therapy With Surgical Treatment Of Peritonsillar Abscess Battaglia, A., et al, Otolaryngol Head Neck Surg 58(2):280, February 2018</ref>		**For patients given above and felt better (must improve clinically), similar results can be obtained compared to I&D<ref>Comparison Of Medical Therapy Alone To Medical Therapy With Surgical Treatment Of Peritonsillar Abscess Battaglia, A., et al, Otolaryngol Head Neck Surg 58(2):280, February 2018</ref>
	**For patients with smaller abscess sizes or less severe symptoms, medical management leads to similar lengths of hospital stay or complications compared to I&D for larger PTAs<Ref>Souza, D. L., Cabrera, D., Gilani, W. I., Campbell, R. L., Carlson, M. L., Lohse, C. M., & Bellolio, M. F. (2016). Comparison of medical versus surgical management of peritonsillar abscess: A retrospective observational study. The Laryngoscope, 126(7), 1529–1534. https://doi.org/10.1002/lary.25960</ref>		**For patients with smaller abscess sizes or less severe symptoms, medical management leads to similar lengths of hospital stay or complications compared to I&D for larger PTAs<Ref>Souza, D. L., Cabrera, D., Gilani, W. I., Campbell, R. L., Carlson, M. L., Lohse, C. M., & Bellolio, M. F. (2016). Comparison of medical versus surgical management of peritonsillar abscess: A retrospective observational study. The Laryngoscope, 126(7), 1529–1534. https://doi.org/10.1002/lary.25960</ref>
Line 142:		Line 143:
	[[Category:ID]]		[[Category:ID]]
	[[Category:Procedures]]		[[Category:Procedures]]

			12. Medical Intervention Alone vs Surgical Drainage for Treatment of Peritonsillar Abscess: A Systematic Review and Meta-analysis. Forner D., et al, Otolaryngology–Head and Neck Surgery 2020, Vol. 163(5) 915–922</ref>

Rossdonaldson1 at 21:58, 13 November 2024

2024-11-13T21:58:33Z

← Older revision		Revision as of 21:58, 13 November 2024
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	==Background==		==Background==
	[[File:Gray1014.png\|thumb\|Anatomy of the posterior pharynx.]]		[[File:Gray1014.png\|thumb\|Anatomy of the posterior pharynx.]]
			[[File:Infrahyoid deep neck spaces.png\|thumb\|Infrahyoid deep neck spaces]]
			[[File:EB1911 - Tongue.png\|thumb\|Neck anatomy at the level of the tongue.]]
			[[File:Human anatomy, including structure and development and practical considerations (1911) (14594049867).jpg\|thumb\|Midline neck anatomy on lateral view.]]
	*Abbreviation: PTA		*Abbreviation: PTA
	*Most common deep head and neck infection in all populations		*Most common deep head and neck infection in all populations

Rossdonaldson1: /* Background */

2024-11-13T21:34:04Z

Background

← Older revision		Revision as of 21:34, 13 November 2024
Line 1:		Line 1:
	==Background==		==Background==
			[[File:Gray1014.png\|thumb\|Anatomy of the posterior pharynx.]]
	*Abbreviation: PTA		*Abbreviation: PTA
	*Most common deep head and neck infection in all populations		*Most common deep head and neck infection in all populations