Tonsillitis, Quinsy (peritonsillar abscess)

Micro-organism

Tonsillitis - 75% viral, otherwise bacterial - Streptococcus pyogenes

Quinsy - polymicrobial

Duration

5 Days

Notes
  • 75% viral - no antibiotics required
  • Send bacterial throat swab (or aspirate if quinsy) and blood for Epstein blood virus (EBV)
  • Send nose and throat swabs in viral transport medium if testing for other viruses is required
First Line

IV Benzylpenicillin 1.2g 6 hourly if unable to swallow

Switch to

Oral Phenoxymethylpenicillin 500mg 6 hourly

Avoid amoxicillin, co-amoxiclav and ampicillin due to probable reactions if glandular fever present.

Penicillin allergy

IV Clarithromycin 500mg 12 hourly if unable to swallow

Oral switch to

Oral Clarithromycin 500mg 12 hourly