Acute Tonsillitis or Quinsy
- Micro-organism
Strep. pyogenes
Qunisy can be polymicrobial
First Line
Phenoxymethylpenicillin PO for 5-10 days (10 days if Scarlet fever)
Use IV benzylpenicillin if severe
Second line: mild intolerance or mild skin reaction
Clarithromycin PO for 5 days
Ceftriaxone IV if severe
Anaphylaxis (including severe skin reaction) to penicillin / cephalosporins
Clarithromycin PO for 5 days
Severe - Vancomycin IV + clindamycin IV/PO for 5 days
- Notes
Only use IV route if patient unable to swallow
It is difficult to differentiate bacterial from viral infection - see information on Sore Throat
If Quinsy - contact ENT