Penicillin Therapy in Acute Tonsillitis, Phlegmonous Tonsillitis and Ulcerative Tonsillitis¹

Protective effect of antibiotics against serious complications of common respiratory tract infections: retrospective cohort study with the UK General Practice Research Database

“…19 We included over a million cases of sore throat treated in the 1990s (compared with 10 101 participants included in the meta-analysis) 6 and showed that antibiotics do indeed reduce the risk of quinsy. As with upper respiratory tract infections and otitis media, however, the number needed to treat to prevent one serious complication is high.…”

Reducing uncertainty in managing respiratory tract infections in primary care

“…The evidence for antibiotics for sore throat preventing quinsy comes largely from a single study in the 1950s of intramuscular penicillin. 18 More recent studies have included only nine cases of quinsy between them, 6,[19][20][21] so robust conclusions are inappropriate.…”

Peritonsillar Abscess

“…77,78 A Cochrane review 21 34 of 120 (28%) patients had repeated tonsillitis in the past Beeden (1970) 22 56 of 111 (50%) patients had previous episodes of tonsillitis Brandow (1973) 23 79 of 156 (51%) patients previously had 1 attacks of tonsillitis Bonding (1973) 24 83 of 317 (26%) patients previously had repeated tonsillitis with fever 3 times per year; 38 of 317 (12%) patients had symptoms of chronic tonsil affection or previously had 1 or 2 episodes of acute tonsillitis per year Herbild (1981) 32 51 of 256 (20%) patients previously had recurrent episodes of tonsillitis and 7% previously had symptoms of pharyngitis in varying degrees Fried (1981) 31 12 of 41 (29%) patients had had 1 episodes of sore throat symptoms Schechter (1982) 91 29 of 74 (39%) patients had a history of tonsillar disease, including 4 patients with previous PTA Stegehuis (1986) 92 22 of 83 (27%) patients previously had 2 attacks of tonsillitis per year over the last 2 y Stringer (1988) 93 10 (36%) patients had a history of tonsillitis, including 5 patients with a history of PTA Savolainen (1993) 94 34 of 98 (35%) and 21 of 98 (21%) patients previously had 1-3 and .3 episodes of tonsillitis, respectively Wolf (1994) 35 34 of 160 (21%) patients had a medical history of recurrent tonsillitis Matsuda (2002) 95 75 of 724 (10%) patients had a history of tonsillar disease, including 48 with prior PTA Ong (2004) 30 23 of 185 (12%) patients gave a history of recurrent tonsillitis 96 45 of 127 (35%) children previously had tonsillar infection in the past 77 This percentage should be regarded with some reservation, as 72% (18 of 25) of the patients who developed PTA were included in 2 nonrandomized and non-double-blinded studies from 1951. [79][80][81][82][83][84][85][86] At that time, the prevalence of PTA in untreated patients was much higher than it is today. Furthermore, some patients were treated with intramuscular penicillin 79 or antibiotics not presently recommended for acute tonsillitis.…”