{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T04:30:17Z","timestamp":1785817817240,"version":"3.56.0"},"reference-count":28,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T00:00:00Z","timestamp":1684281600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Laryngol. Otol."],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0022215123000804_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Peritonsillar abscess is a localised infection in the peritonsillar space. Pus from the abscess can contain anaerobes. Many clinicians prescribe metronidazole in addition to penicillin, but evidence to support this is limited. This review assessed the evidence of benefit of metronidazole for the treatment of peritonsillar abscess.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215123000804_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>A systematic review was conducted of the literature and databases including Ovid Medline, Ovid Embase, PubMed and Cochrane library. Search terms included all variations of peritonsillar abscess, penicillin and metronidazole.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215123000804_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Three randomised, control trials were included. All studies assessed the clinical outcomes after treatment for peritonsillar abscess, including recurrence rate, length of hospital stay and symptom improvement. There was no evidence to suggest additional benefit with metronidazole, with studies suggesting increased side effects.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215123000804_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusion<\/jats:title><jats:p>Evidence does not support the addition of metronidazole in first-line management of peritonsillar abscess. Further trials to establish optimum dose and duration schedules of oral phenoxymethylpenicillin would benefit clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0022215123000804","type":"journal-article","created":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T11:30:45Z","timestamp":1684323045000},"page":"992-996","source":"Crossref","is-referenced-by-count":2,"title":["A systematic review of the role of penicillin versus penicillin plus metronidazole in the management of peritonsillar abscess"],"prefix":"10.1017","volume":"137","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6322-5002","authenticated-orcid":false,"given":"C M","family":"Moen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Paramjothy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Williamson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Coleman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X","family":"Lou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5564-1513","authenticated-orcid":false,"given":"C M","family":"Douglas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2023,5,17]]},"reference":[{"key":"S0022215123000804_ref2","first-page":"199","article-title":"Peritonsillar abscess","volume":"77","author":"Galioto","year":"2008","journal-title":"Am Fam Physician"},{"key":"S0022215123000804_ref24","unstructured":"24 Ottawa Hospital Research Institute. Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analysis. In: http:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp [20 December 2021]"},{"key":"S0022215123000804_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-323-44585-6.00007-2"},{"key":"S0022215123000804_ref13","doi-asserted-by":"publisher","DOI":"10.1542\/peds.112.5.e380"},{"key":"S0022215123000804_ref10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-4486.2007.01575.x"},{"key":"S0022215123000804_ref12","volume-title":"Scott-Brown's Otolaryngology, Head and Neck Surgery","author":"Scott-Brown","year":"2008"},{"key":"S0022215123000804_ref7","doi-asserted-by":"publisher","DOI":"10.1086\/644616"},{"key":"S0022215123000804_ref6","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e318182a4fb"},{"key":"S0022215123000804_ref5","first-page":"B5333","article-title":"Peritonsillar abscess: clinical aspects of microbiology, risk factors, and the association with parapharyngeal abscess","volume":"64","author":"Klug","year":"2017","journal-title":"Dan Med J"},{"key":"S0022215123000804_ref15","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkw038"},{"key":"S0022215123000804_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(99)70370-0"},{"key":"S0022215123000804_ref19","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"S0022215123000804_ref21","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1007\/s004050050035","article-title":"A comparison of procaine penicillin with sulbactam-ampicillin in the treatment of peritonsillar abscesses","volume":"255","author":"Yilmaz","year":"1998","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"S0022215123000804_ref23","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"S0022215123000804_ref4","first-page":"CD006287","article-title":"Needle aspiration versus incision and drainage for the treatment of peritonsillar abscess","volume":"2016","author":"Chang","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"S0022215123000804_ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-014-2260-2"},{"key":"S0022215123000804_ref25","doi-asserted-by":"publisher","DOI":"10.1136\/pmj.78.923.545"},{"key":"S0022215123000804_ref26","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bdj.2018.221"},{"key":"S0022215123000804_ref8","first-page":"15","article-title":"Appraisal of the peri-hospital management and evolving microbiology of peritonsillar abscess disease","volume":"10","author":"Ryan","year":"2014","journal-title":"B-ENT"},{"key":"S0022215123000804_ref27","unstructured":"27 World Health Organization. New report calls for urgent action to avert antimicrobial resistance crisis. https:\/\/www.who.int\/news\/item\/29-04-2019-new-report-calls-for-urgent-action-to-avert-antimicrobial-resistance-crisis [25 March 2023]"},{"key":"S0022215123000804_ref20","doi-asserted-by":"publisher","DOI":"10.1007\/BF01643477"},{"key":"S0022215123000804_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-6665(20)31644-3"},{"key":"S0022215123000804_ref1","doi-asserted-by":"publisher","DOI":"10.1080\/00365540802195226"},{"key":"S0022215123000804_ref22","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.35.6.1219"},{"key":"S0022215123000804_ref18","doi-asserted-by":"publisher","DOI":"10.4137\/PMC.S14459"},{"key":"S0022215123000804_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)57035-4"},{"key":"S0022215123000804_ref17","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofx270"},{"key":"S0022215123000804_ref9","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215109991939"}],"container-title":["The Journal of Laryngology &amp; Otology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0022215123000804","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T08:12:53Z","timestamp":1693987973000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0022215123000804\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,17]]},"references-count":28,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["S0022215123000804"],"URL":"https:\/\/doi.org\/10.1017\/s0022215123000804","relation":{},"ISSN":["0022-2151","1748-5460"],"issn-type":[{"value":"0022-2151","type":"print"},{"value":"1748-5460","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,17]]}}}