Antimicrobial prescribing: NHS Grampian, Orkney & Shetland
Important: Therapy
- 75% viral - no antibiotics required
- Send bacterial throat swab (or aspirate if quinsy) and blood for Epstein blood virus (EBV)
- Send nose and throat swabs in viral transport medium if testing for other viruses is required
Tonsillitis, Quinsy (peritonsillar abscess)
Micro Organisms
Tonsillitis - 75% viral, otherwise bacterial - Streptococcus pyogenes
Quinsy - polymicrobial
Duration
5 Days
Important: Therapy
IV Benzylpenicillin 1.2g 6 hourly if unable to swallow
Switch to
Oral Phenoxymethylpenicillin 500mg 6 hourly
Notes:
Avoid amoxicillin, co-amoxiclav and ampicillin due to probable reactions if glandular fever present.
Important: Therapy
IV Clarithromycin 500mg 12 hourly if unable to swallow
Oral switch to
Oral Clarithromycin 500mg 12 hourly