Suspected Pharyngitis or Peritonsillar Abscess (PTA) Clinical Pathway — Emergency Department and Inpatient
Suspected Pharyngitis or Peritonsillar Abscess (PTA) Clinical Pathway — Emergency Department and Inpatient
Inpatient Management
Inpatient with suspected or confirmed PTA
- Continue IV Antibiotics
- Consider ENT consult/NPO nightly for potential surgical intervention
- IV Fluids
Good clinical response
No improvement after 24-48 hrs
- Continued fevers/no improvement in fever curve
- Persistent or new trismus
- No improvement in drooling or ability to PO
- Consult ENT
- Consider dexamethasone 0.6 mg/kg/dose once, max 8 mg
- CT neck w/IV contrast, initial or repeat
- If CT requires general anesthesia
- ENT, Radiology, Anesthesia discuss completing as single procedure
- OR as indicated
Good clinical response
Discharge
- Transition to oral antibiotics to complete treatment duration
- If symptoms are not resolved, PCP follow-up
- Antibiotic Recommendations