A systematic review of the role of penicillin vs penicillin plus metronidazole in the management of peritonsillar abscess.

Moen, C. M., Paramjothy, K., Williamson, A., Coleman, H., Lou, X., Smith, A. and Douglas, C. M. (2023) A systematic review of the role of penicillin vs penicillin plus metronidazole in the management of peritonsillar abscess. Journal of Laryngology and Otology, 137(9), pp. 992-996. (doi: 10.1017/S0022215123000804) (PMID:37194922)

Abstract

Background. Peritonsillar abscess is a localised infection in the peritonsillar space. Pus from the abscess can contain anaerobes. Many clinicians prescribe metronidazole in addition to penicillin, but evidence to support this is limited. This review assessed the evidence of benefit of metronidazole for the treatment of peritonsillar abscess. Methods. A systematic review was conducted of the literature and databases including Ovid Medline, Ovid Embase, PubMed and Cochrane library. Search terms included all variations of peritonsillar abscess, penicillin and metronidazole. Results. Three randomised, control trials were included. All studies assessed the clinical outcomes after treatment for peritonsillar abscess, including recurrence rate, length of hospital stay and symptom improvement. There was no evidence to suggest additional benefit with metronidazole, with studies suggesting increased side effects. Conclusion. Evidence does not support the addition of metronidazole in first-line management of peritonsillar abscess. Further trials to establish optimum dose and duration schedules of oral phenoxymethylpenicillin would benefit clinical practice.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Paramjothy, Dr Kiara and Williamson, Mr Andrew and Douglas, Miss Catriona and Moen, Dr Christy and Smith, Professor Andrew
• Authors: Moen, C. M., Paramjothy, K., Williamson, A., Coleman, H., Lou, X., Smith, A., and Douglas, C. M.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
• Journal Name: Journal of Laryngology and Otology
• Publisher: Cambridge University Press
• ISSN: 0022-2151
• ISSN (Online): 1748-5460
• Published Online: 17 May 2023
• Copyright Holders: Copyright © 2023 Cambridge University Press
• First Published: First published in Journal of Laryngology and Otology 137(9):992-996
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher