The recurrence rate after aspiration is 10% and the cure rate is 93% to 95%.  Recurrence rate for aspiration alone may be higher than I&D 
May need IV pain meds, sedation or procedural sedation
Glycopyrrolate can reduce secretions
Glycopyrrolate can reduce secretions
Use static ultrasound to determine depth of vasculature.
Though always a concern, carotid injury has not been clearly documented as a complications
May require multiple aspirations to find the<unk> 
First try superior then middle then inferior poles
Consider spinal needle if patient has significant trismus
First try superior then middle then inferior poles
The medications below and ED observation for 1-2 hours after, with liquid PO challenge:
D5-1/2 NS, 1 L bolus
Dexamethasone 10 mg IV
Ceftriaxone 2 g IV
Clindamycin 600 mg IV
Upon discharge, Clindamycin 300 mg PO QID x10 days
Pediatric protocol is the same, with weight based dosing
Studies
For patients given above and felt better (must improve clinically), similar results can be obtained compared to I&D
For<unk> es <2 cm, the treatment-failure rate is 5% for antibiotics alone. 
D5-1/2 NS, 1 L bolus
Dexamethasone 10 mg IV
Ceftriaxone 2 g IV
Clindamycin 600 mg IV
Upon discharge, Clindamycin 300 mg PO QID x10 days
Pediatric protocol is the same, with weight based dosing
For patients given above and felt better (must improve clinically), similar results can be obtained compared to I&D
For<unk> es <2 cm, the treatment-failure rate is 5% for antibiotics alone. 
Coverage for Streptococcus species, anerobes, Eikenella, H. influenza, S. auresus
Clindamycin 300mg PO Q6hrs x7-10d
Amoxicillin/Clavulanate 875 mg PO BID x 7-10d
Penicillin V 500mg PO + Metronidazole 500mg QID
Ampicillin/Sulbactam 3 gm (75mg/kg) IV four times daily
Pipericillin/Tazobactam 4.5 gm IV TID
Ticarcillin/Clavulanate 3.1 g IV QID
Clindamycin 600-900mg IV TID
Penicillin G 4 million units (50,000 units/kg) IV four times daily + Metronidazole 500mg IV three times daily
Decreases duration and severity of pain
Methylprednisolone 125mg IV x1 OR dexamethasone 10mg PO/IM x1
Peritonsillar abscess
Streptococcal pharyngitis 
Peritonsillar cellulitis
Neisseria gonorrhoeae
Retropharyngeal abscess
Diphtheria 
Epiglottitis
Bacterial Tracheitis