Tonsillitis and Peritonsillar Abscess Medication

Updated: Jan 19, 2017
  • Author: Udayan K Shah, MD, FACS, FAAP; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Medication

Medication Summary

Medications that are used to manage tonsillitis include antibiotics, anti-inflammatory agents (eg, corticosteroids), antipyretics and analgesics (eg, acetaminophen, ibuprofen), and immunologic agents (eg, gamma globulin).

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Corticosteroids

Class Summary

Corticosteroids have anti-inflammatory properties and cause profound and varied metabolic effects. These agents modify the body's immune response to diverse stimuli. Corticosteroids reduce inflammation, which may impair swallowing and breathing.

Dexamethasone (Baycadron)

Dexamethasone is a short-acting, rapid-onset glucocorticoid.

Prednisone

Prednisone decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reducing capillary permeability.

Prednisolone (Pediapred, Millipred, Orapred)

Prednisolone decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reducing capillary permeability.

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Antibiotics, Other

Class Summary

Antibiotic therapy must be comprehensive and cover all likely pathogens in the context of this clinical setting.

Penicillin G benzathine (Bicillin L-A)

Penicillin interferes with synthesis of cell wall mucopeptides during active multiplication, which results in bactericidal activity.

Clarithromycin (Biaxin)

Clarithromycin inhibits bacterial growth, possibly by blocking dissociation of peptidyl tRNA from ribosomes causing RNA-dependent protein synthesis to arrest. It is a semisynthetic macrolide with twice-daily dosing.

Clindamycin (Cleocin)

Clindamycin is an oral or parenteral antibiotic that is used for the treatment of anaerobic or susceptible streptococcal, pneumococcal, or staphylococcal species. It is considered to have good absorption into the bloodstream in both oral and parenteral forms.

Vancomycin

Vancomycin is indicated for patients who cannot receive or have failed to respond to penicillins and cephalosporins or who have infections with resistant staphylococci. To avoid toxicity, the current recommendation is to assay vancomycin trough levels after the third dose, drawn 30 minutes prior to the next dosing. Use creatinine clearance (CrCl) to adjust the dose in patients diagnosed with renal impairment. It is used in conjunction with gentamicin for prophylaxis in penicillin-allergic patients undergoing gastrointestinal or genitourinary procedures.

Rifampin (Rifadin)

Rifampin is an inhibitor of bacterial DNA-dependent RNA polymerase activity.

Amoxicillin (Moxatag)

Amoxicillin is an oral antibiotic with specific activity against penicillin-resistant organisms; it is often combined with the beta-lactamase inhibitor clavulanic acid.

Amoxicillin and clavulanate (Augmentin, Amoclan, Augmentin XR)

Amoxicillin is a third-generation aminopenicillin. Combined with the beta-lactam clavulanic acid, it is less susceptible to degradation by beta-lactamases produced by microorganisms.

Metronidazole (Flagyl)

Metronidazole is effective in patients with tonsillitis and mononucleosis, for shortening fever duration and reducing tonsillar size, and in management of acute episodes of nonstreptococcal tonsillitis.

Ampicillin and sulbactam (Unasyn)

This is a drug combination of a beta-lactamase inhibitor with ampicillin. It interferes with bacterial cell wall synthesis during active replication, causing bactericidal activity against susceptible organisms. It is an alternative to amoxicillin/clavulanate if the patient is unable to take medication orally.

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Immune Globulins

Class Summary

These agents are used to improve clinical aspects of the disease. It stimulates immune cells, reducing the severity of infection.

Immune globulin intravenous (Gammagard, Gamunex-C, Octagam)

Intravenous immune globulin is pooled human immune globulin. Because of a shortage of supply, it is reserved for use for severe infections. It should be used in accordance with institutional policies. Its use in the past was more common for various indications.

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Analgesics, Other

Class Summary

Pain and fever control are essential to quality patient care. Analgesics with antipyretic properties ensure patient comfort, promote pulmonary toilet, and have sedating properties, which are beneficial for patients who experience pain.

Aspirin (Bayer Aspirin, Ecotrin, Aspercin, Ascriptin, Bufferin)

Aspirin lowers elevated body temperature by dilating peripheral vessels, enhancing the dissipation of excess heat. It also acts on the heat-regulating center of the hypothalamus to reduce fever.

Ibuprofen (Motrin, Advil, NeoProfen, Caldolor, Ultraprin)

Ibuprofen is one of the few nonsteroidal anti-inflammatory drugs (NSAIDs) indicated for reduction of fever.

Acetaminophen (Tylenol, APAP 500, Mapap, FeverAll)

Acetaminophen reduces fever by acting directly on hypothalamic heat-regulating centers, thereby bringing about increased dissipation of body heat with vasodilation and sweating.

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