Evaluation of ambulatory peritonsillar abscess management in our institution - our experience with 47 patients
The aim was to establish the clinical course of patients admitted with a peritonsillar abscess and to evaluate the effectiveness of ambulatory management. A two cycle audit was completed over a nine month period. Retrospective data was collected on all patients admitted with a confirmed peritonsillar abscess. Data collected included basic patient demographics, duration of admission, medications prescribed and volume of aspirate obtained. Duration of admission was noted to be short (mean = 1.35 nights) and from this an ambulatory quinsy protocol was initiated. Prospective data was collected to evaluate effectiveness, which was judged according to patient response at follow up (telephone consultation) and readmission/aspiration rate. Twenty three patients were identified over a six month period within the prospective cycle (n=23). Of these, seventy percent (n=16) were eligible for day case management. Exclusion criteria included sepsis, respiratory distress and persistent dysphagia following antibiotic therapy and aspiration. Review twenty four hours post discharge, via telephone consultation, confirmed continued recovery in three quarters (n=12) of ambulatory patients. Our data demonstrates that peritonsillar abscess could be managed according to an ambulatory protocol. Savings per patient average £273, highlighting the financial benefit of rapid assessment, management and discharge of this patient group.