Peritonsillar Abscess: A Prospective Evaluation of Outpatient Management by Needle Aspiration

Outpatient management of peritonsillar abscess by needle aspiration and oral antibiotic therapy was evaluated for its effectiveness in providing rapid symptom relief and cure and in preventing recurrence. Between 1984 and 1987, 124 patients with peritonsillar infection were treated in our department, and 115 were included in this prospective study. Needle aspiration was not carried out in 11 patients because of young age, noncooperation, or severe trismus. The other 104 patients underwent permucosal aspiration and were followed up for periods of four months to three years. Of these, findings of aspiration were positive in 75 (72%). Only nine (12%) of the 75 patients with positive aspirates had to be hospitalized. In 64 (85%) of the 75 patients, the abscess resolved without further therapy. Aspiration of pus, along with oral administration of antibiotics, thus appears to be a reasonable alternative to incision and drainage or “hot” tonsillectomy in patients with peritonsillar abscess. This conservative approach obviates the need for hospital admission in most patients, thus enabling a significant cost reduction. (Arch Otolaryngol Head Neck Surg 1988;114:661-663)