Peritonsillar abscess - Treating quinsy

Quinsy, also known as a peritonsillar abscess, is usually treated with a combination of medication and surgery.

Medication

Antibiotics

If you are diagnosed with quinsy, you will be prescribed a course of antibiotics to treat the infection. The antibiotics will usually be given directly into a vein (intravenously). This method is more effective than taking antibiotics tablets.

Antibiotics often used to treat quinsy include:

• phenoxymethylpenicillin, also called penicillin V - a type of penicillin
• clarithromycin, if you are allergic to penicillin 
• amoxicillin
• clindamycin 
• erythromycin 

Several different antibiotics are available. The choice will depend on the type of bacteria causing your infection and what medicines suit you best. For example, some types of medication may not be suitable if you have another medical condition, such as liver or kidney problems.

Some types of antibiotics may interact with some types of contraception, such as the combined contraceptive pill. If this affects you, the healthcare professionals treating you will advise about which other contraception is suitable to use during this time.

Corticosteroids

Corticosteroids are medicines that contain steroids, a type of hormone. They help reduce swelling and may be used to treat quinsy. If you have a severe sore throat or severe difficulty swallowing, corticosteroids may be considered.

Studies have found that corticosteroids are a safe and effective method of treating quinsy.

Painkillers

If you have quinsy, you may be prescribed painkillers to help ease any pain you have. The most commonly prescribed painkillers are paracetamol and ibuprofen.

Surgery

In most cases of quinsy, antibiotics alone are not an effective treatment, and a surgical procedure is also required. Procedures that may be used include:

• needle aspiration
• incision and drainage
• tonsillectomy

These are briefly described below.

Needle aspiration

Needle aspiration may be used to drain the build-up of fluid from the abscess. The procedure involves using a long, fine needle to draw out the pus. If you have needle aspiration, you will usually be given medication called a sedative to help you relax, or a local anaesthetic may be used to numb the area so you do not feel any pain.

After the procedure, fluid removed from the abscess will be sent to a laboratory to identify the bacteria that caused the infection.

Incision and drainage

In some cases, a cut will be made in the affected area to drain the fluid from the abscess. This is called incision and drainage.

Incision and drainage is performed either under sedation to relax you, local anaesthetic to numb the area, or general anaesthetic to put you to sleep.

Tonsillectomy

A tonsillectomy is an operation to remove your tonsils. These are the two small glands found at the back of your throat, behind your tongue. A tonsillectomy may be recommended in severe cases of quinsy or if you have recurring bouts of sore throats.

Read about how tonsillitis is treated for more information about tonsillectomies.

Hospital treatment

Depending on how severe your infection is, you may need to spend two to four days being treated for quinsy in hospital.

During this time, medicines and fluids will be given to you through a drip in your arm.

After leaving hospital, you may need to rest at home for up to a week. You will probably be given antibiotics and painkillers to take at home.