The role of anaerobic bacteria in peritonsillar abscesses

Peritonsillar abscess (quinsy) is a complication of acute bacterial tonsillitis. Its treatment remains controversial. Needle drainage of the abscess may provide an alternative to incision or tonsillectomy. An important element of controversy is the choice of antibiotics after surgical drainage of the abscess. Results of many studies support the resistance of grown bacteria to many antibiotics and the potential importance of anaerobic bacteria in development of peritonsillar abscesses. Although bacteria grown from the pus vary among the continents, clinical implications resulting from the microbiological studies are similar. Patients with peritonsillar abscesses should be treated with antibiotics effective against both aerobic and anaerobic bacteria. In the routine management of peritonsillar abscess, bacteriologic studies are unnecessary on initial presentation. It is, however, necessary to consider infection with anaerobes. Therefore, penicillin and metronidazole are recommended as the antibiotic regimen of choice in the treatment of peritonsillar abscesses. If this treatment is ineffective, broad-spectrum antibiotics (clindamycin) should be administered.