A peritonsillar abscess, also known as a quinsy, is a painful bacterial infection that forms at the back of the throat near one of the tonsils^[1]. The infection spreads outwards into the area around the tonsil, pushing the tonsil inward and causing the soft palate to bulge. A quinsy is a rare and potentially serious condition, so it’s important to be able to recognise the symptoms and get suitable treatment quickly. 

The signs of a peritonsillar abscess include a severe sore throat that worsens quickly^[2]. Usually, you will feel it on one side of your throat. You may also notice swelling inside your throat and mouth and have difficulty opening your mouth more than a centimetre or so. You might struggle to swallow too. Other potential symptoms to be aware of include bad breath, earache on the side affected by the abscess, a headache and feeling generally unwell.

So, if you suspect you might have a quinsy, what should you do? 

Can a peritonsillar abscess heal on its own? 

Firstly, it’s important to be aware that a peritonsillar abscess will not heal on its own^[3]. This means that, unlike with certain other throat infections, you shouldn’t simply wait for it to get better or rely on over the counter medicines or home remedies such as gargles. While treatments like Ultra Chloraseptic’s anaesthetic throat spray range can help to ease the symptoms of sore throats, you will need treatment from a doctor to tackle the infection.  

If you think that you have a quinsy, you should see your GP as soon as possible. They will examine your throat and ask you about your symptoms. If they suspect you have this condition, they will refer you immediately to an ear, nose and throat specialist in a hospital for further tests.  

Treating the infection quickly will help to prevent it from spreading and mean you avoid potentially serious problems such as severe swelling of the throat and breathing difficulties.  

How to treat a peritonsillar abscess

A peritonsillar abscess is treated with antibiotics^[4]. Because these infections are bacterial, they typically respond very well to this type of treatment. The antibiotics are usually given directly into a vein via a drip rather than being administered as a syrup or tablets. If the infection is treated while it is still in its early stages, it usually clears up quickly. You can expect to start to feel better within 24 to 48 hours. Once you can swallow more easily, you will be taken off the drip and given a course of antibiotic tablets to take at home.

However, if the infection is more advanced by the time you get to hospital and pus has formed in the abscess, this will need to be drained. There are various ways that this can be done. A doctor may use a needle and syringe to drain the fluid, or if the abscess is large, they might lance it with a scalpel to help ensure it drains properly. You will usually stay awake for these procedures, but you will be given a local anaesthetic to numb the pain, and you might also be given a sedative to relax you.

In cases of recurrent peritonsillar abscesses, it might be necessary to surgically remove the tonsils. However, this procedure is rarely carried out while patients still have a quinsy. Usually, doctors wait for at least six weeks after the patient has recovered before they carry out this operation.

What antibiotics treat a peritonsillar abscess?

Common penicillins like amoxicillin are often used to treat peritonsillar abscesses. Sometimes, a second antibiotic is added to the treatment. If you are allergic to penicillin, doctors will use alternatives, such as clarithromycin.

Resources:

[1] https://www.nidirect.gov.uk/conditions/quinsy#toc-0

[2] https://www.nhs.uk/conditions/tonsillitis/#:~:text=you%20have%20a,signs%20of%20quinsy.

[3] https://kidshealth.org/en/teens/peritonsillar-abscess.html

[4] https://www.dchft.nhs.uk/wp-content/uploads/2020/10/Quinsy-August-2020.pdf