Dreigend peritonsillair abces

Antimicrobial management of an imminent peritonsillar abscess is still under debate. Clinical experience shows that early administration of amoxicillin-clavulanic acid could prevent unilateral peritonsillitis from developing into an abscess. Here we describe two patients who initially received penicillin V treatment. They both recovered but only after the ENT specialist switched their antibiotic treatment to amoxicillin-clavulanic acid. Although sound evidence is lacking, we suggest that the Practice Guidelines should be revised. In the primary health care setting, amoxicillin-clavulanic acid should become the first drug of choice for patients presenting with unilateral peritonsillar swelling and trismus in situations where the patient is still able to eat and drink and can be seen again within 24 hours.

Conflict of interest: S. Zwart is a former president of the Post Academic Education for General Practitioners (PAO-H) in Utrecht and received payments for educational courses for general practitioners in 2010 and 2011. He also receives royalties for his co-authorship of the book Diagnostiek van alledaagse klachten. Financial support for this article: none declared.