An evidence-based review of the treatment of peritonsillar abscess

Peritonsillar abscess (PTA) is a collection of pus within the space between the tonsil and the superior constrictor muscle, near the tonsils superior pole. It is associated with tonsillitis & comprises approximately 30% of soft tissue head and necka bscesses. PTA is most common in adolescents and young adults. The bacteriology Streptococcus sp.most common organism cultured.

Does the Use of Steroids as Adjuvant Treatment Improve Treatment Outcome in PTA?

a rct for severe, acute pharyngitis,8 in which the use of adjuvant steroids demonstrated benefit. The authors 1 dose of intramuscular dexamethasome (10 mg) faster improvement in throat pain than controls.

Which Technique of Surgical Drainage Has the Highest Success Rate? PTA Needle aspiration, incision & drainage (I&D), and simultaneous tonsillectomy with open abscess drainage (or, quinsy tonsillectomy). Others I&D to be followed by tonsillectomy a few weeks latercalled interval tonsillectomy.

Which Technique of Surgical Drainage Has the Highest Success Rate?

 I&D is slightly more effective in initial success rate than needle aspiration (93.7% versus 91.6%), so the NNT was 47.6 patients, in favor of I&D.

What Is the Recurrence Rate of PTA and What Are the Indications for Elective Tonsillectomy to Prevent Recurrence?

The recurrence rate of PTA and the relative indications for tonsillectomy. The Kronenberg et al patients with a history of recurrent tonsillitis had a significantly greater risk of recurrent PTA than did patients with no history of recurrent tonsillitis (40% versus 10.5%, P 0.0001).

 Clinical research evidence not support or refute the use of steroids in PTA. The success rates with initial I&D or needle aspiration are both very high initial treatment. The overall recurrence rate of PTA is low, but in selected subgroups of patients, elective tonsillectomy may provide benefit by decreasing the risk of