What is the treatment for tonsillitis?
Having no treatment at all is one option. Many tonsil infections are mild and soon get better on their own. Treatment options include.
- Have plenty to drink. It is tempting not to drink very much if it is painful to swallow. You may become mildly lacking in fluid in the body (mildly dehydrated) if you don't drink much, particularly if you also have a high temperature (fever). Some lack of fluid in the body can make headaches and tiredness much worse.
- Paracetamol or ibuprofen eases pain, headache and fever. To keep symptoms to a minimum it is best to take a dose at regular intervals as recommended on the packet of medication rather than now and then. For example, take paracetamol four times a day until symptoms ease. Although either paracetamol or ibuprofen will usually help, there is some evidence to suggest that ibuprofen may be more effective than paracetamol at easing symptoms in adults. Paracetamol is usually the preferred first-line option for children, but ibuprofen can be used as an alternative. Note: some people with certain conditions may not be able to take ibuprofen. So, always read the packet label.
- Other gargles, lozenges and sprays that you can buy at pharmacies may help to soothe a sore throat. However, they do not shorten the illness.
Do I need an antibiotic for tonsillitis?
Usually not. Most throat and tonsil infections are caused by germs called viruses, although some are caused by germs called bacteria. Without tests, it is usually not possible to tell if it is a viral or bacterial infection. Antibiotics kill bacteria, but do not kill viruses.
Even if a bacterium is the cause of a tonsil or throat infection, an antibiotic does not make much difference in most cases. Your body defences (immune system) usually clear these infections within a few days whether caused by a virus or a bacterium. Also, antibiotics can sometimes cause side-effects such as diarrhoea, rash and stomach upsets.
So, most doctors do not prescribe antibiotics for most cases of tonsillitis or sore throat.
An antibiotic may be advised in certain situations. For example:
- If the infection is severe.
- If it is not easing after a few days.
- If your immune system is not working properly (for example, if you have had your spleen removed, if you are taking chemotherapy, etc).
What about having my tonsils taken out?
If you have repeated (recurring) tonsillitis you may wonder about having your tonsils removed. Guidelines suggest it may be an option to have your tonsils removed (tonsillectomy) if you:
- Have had seven or more episodes of tonsillitis in the preceding year; or
- Five or more such episodes in each of the preceding two years; or
- Three or more such episodes in each of the preceding three years.
- And ...
- The bouts of tonsillitis affect normal functioning. For example, they are severe enough to make you need time off from work or from school.
The adenoids may also be removed at the same time. The adenoids are also part of the body's defence against infections (the immune system). Adenoids hang from the upper part of the back of the nasal cavity. See separate leaflet called Tonsils and Adenoids for more details.
Although full-blown episodes of tonsillitis are prevented after tonsillectomy, other throat infections are not prevented. However, the overall number and severity of throat infections may be reduced. Also, the risk of developing quinsy is reduced. Many people say they generally feel better in themselves after having their tonsils removed if they previously had frequent episodes of tonsillitis.
Tonsillectomy is usually a straightforward minor operation. But, as with all operations, there is a risk. For example, there is a small risk of life-threatening severe bleeding from the throat during or just after the operation.
Did you find this information useful?
- Tonsillectomy; Royal College of Surgeons, 2016
- Burton MJ, Glasziou PP, Chong LY, et al; Tonsillectomy or adenotonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis. Cochrane Database Syst Rev. 2014 Nov 19 (11):CD001802. doi: 10.1002/14651858.CD001802.pub3.
- Spinks A, Glasziou PP, Del Mar CB; Antibiotics for sore throat. Cochrane Database Syst Rev. 2013 Nov 5 11:CD000023.
- Respiratory tract infections (self-limiting): prescribing antibiotics; NICE Clinical Guideline (July 2008)
- Management of sore throat and indications for tonsillectomy; Scottish Intercollegiate Guidelines Network - SIGN (April 2010)
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