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Experiencing (or having your child experience) a sore throat, swollen tonsils, and difficulty swallowing can be difficult and frustrating. These symptoms commonly indicate a case of tonsillitis or inflammation of the tonsils. Understanding what tonsillitis is and how to treat it are great first steps in starting to feel better. Let’s take a look at what this condition is and what can be done to treat it.
What is tonsillitis?
Tonsils are the two small lumps of soft tissue at the back of the throat—one on each side. Along with the adenoids, tonsils are part of the immune system, trapping germs that can make you sick. Tonsillitis, also called pharyngitis, is an inflammation of the tonsils.Tonsillitis is more common in children than adults and may be caused by a virus or bacteria. Common symptoms of tonsillitis may include:
- A sore, scratchy throat that appears suddenly
- Painful swallowing
- Swollen tonsils (they may be red or have white spots)
- Sores or blisters on the throat
- Snoring or sleep apnea
- Bad breath
- Headache
- Loss of appetite
- Fever
- Chills
- Tiredness and weakness
- Swollen lymph nodes around the neck
Bacteria cause other cases of tonsillitis, often Group A Streptococcus. Bacterial tonsillitis is commonly referred to as strep throat. When tonsillitis is caused by bacteria, it is treated with a course of antibiotics such as a penicillin or another antibiotic. An antibiotic helps to eliminate the infection, as well as prevent serious complications such as scarlet fever, rheumatic fever, and kidney damage. Some people, who get frequent infections—or have a complication called a peritonsillar abscess, will even need outpatient surgery.
How is tonsillitis diagnosed?
Because bacterial tonsillitis can cause serious complications if untreated, it is important to see a healthcare provider if you have symptoms of tonsillitis. The provider can determine if your infection is viral or bacterial. You can see a primary care provider (or pediatrician for a child), an urgent care provider, or an ear, nose, and throat (ENT) doctor, also known as an otolaryngologist.At the appointment, the healthcare provider will:
- Ask questions about symptoms
- Take a medical history
- Examine the patient, checking the throat, lymph nodes, and ears
- Take a throat swab to check for strep throat
Tonsillitis treatment options
Viral infection
Patients with a viral infection will not require antibiotics. The viral infection will go away on its own in a few days. You or your child can take over-the-counter (OTC) medications for throat pain or fever, such as Motrin (ibuprofen) or Tylenol (acetaminophen). Children under 18 years old should not take aspirin due to the risk of Reye’s syndrome.Bacterial infection
Bacterial tonsillitis requires a course of antibiotics. A 10-day course of penicillin or a penicillin-type antibiotic like amoxicillin or Augmentin is commonly prescribed. However, due to allergies or other individual factors, another antibiotic may be more suitable. Patients with a bacterial infection should always finish the complete course of antibiotics prescribed. This ensures the infection goes away, and does not return. It also helps prevent antibiotic resistance. Additionally, people with a bacterial infection can also take OTC pain or fever medications to reduce symptoms, in addition to antibiotics.Bacterial tonsillitis medications
A 10-day course of penicillin or a drug in the penicillin class is often prescribed for bacterial tonsillitis. However, another antibiotic may be used due to patient allergies or another individual reason.Penicillin antibiotics
Penicillin, or another drug in the penicillin class of medications, is generally prescribed for ten days as first-line treatment for bacterial strep infection. Examples include penicillin or amoxicillin. Augmentin (amoxicillin and clavulanate) is a penicillin antibiotic that contains amoxicillin—and also contains clavulanate which is called a beta-lactamase inhibitor. Clavulanate helps prevent the bacteria from destroying amoxicillin. Common side effects of drugs in the penicillin class include stomach problems like nausea, vomiting, diarrhea, and stomach pain—as well as rash, yeast infection, and a black, hairy tongue.Cephalosporin antibiotics
A cephalosporin antibiotic, such as Keflex (cephalexin), is another popular choice of drug for bacterial tonsillitis. It’s generally prescribed to be taken twice a day for ten days. Cephalosporins are similar in structure and function to penicillin antibiotics. Common side effects include nausea, vomiting, diarrhea, stomach pain, and indigestion.Macrolide antibiotics
A 5-day course of Zithromax (azithromycin) may be a suitable choice for a patient who is allergic to penicillins and/or cephalosporins. Zithromax is a macrolide antibiotic and is in the same drug class as medications like erythromycin and Biaxin (clarithromycin). Common side effects include nausea, vomiting, diarrhea, stomach pain, indigestion, rash, gas, headache, dizziness, and vaginal yeast infections.Clindamycin
A 10-day course of Cleocin (clindamycin) is another alternative in penicillin-allergic patients. It’s classified as a lincosamide antibiotic. Common side effects include nausea, vomiting, diarrhea, stomach pain, rash, itching, and jaundice (yellowing of the skin and whites of the eyes).What is the best medication for bacterial tonsillitis?
The best medication for bacterial tonsillitis depends on various factors. Although penicillin and drugs in the penicillin class (such as amoxicillin) are considered first-line treatments, not every patient can take medication from this drug class due to allergies or other individual factors. If you have bacterial tonsillitis, your healthcare provider will determine the most appropriate medication to treat your infection.The chart below lists the most popularly prescribed medications for bacterial tonsillitis.
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Best medications for tonsillitis
| Drug name | Learn more | See SingleCare price |
|---|---|---|
| Amoxicillin | amoxicillin details | Get free coupon |
| Augmentin | augmentin details | Get free coupon |
| Cleocin | cleocin details | Get free coupon |
| Keflex | keflex details | Get free coupon |
| Penicillin V Potassium | penicillin-v-potassium details | Get free coupon |
| Zithromax | zithromax details | Get free coupon |
*Dosage may vary; this is a typical dosage. Dosage is determined by your doctor based on individual factors. Other possible side effects exist. This is not a complete list.
Other medications that may be recommended or prescribed, that are not antibiotics, include:
- Over-the-counter pain relievers/fever reducers such as Tylenol (acetaminophen) or Advil (ibuprofen). Children under 18 years old should not take aspirin.
- Oral corticosteroids (steroids), such as dexamethasone, may be prescribed if the tonsils are so swollen that they interfere with breathing.
What are the common side effects of bacterial tonsillitis medication?
Common side effects of all antibiotics include:- Stomach problems like nausea, vomiting, diarrhea, indigestion, and stomach pain
- Yeast infections
- Headache
- Dizziness
- Rash
What are some severe side effects of bacterial tonsillitis medication?
Sometimes, serious side effects can occur. For example, a severe allergic reaction may develop. Symptoms may include hives, difficulty breathing, and swelling of the face, lips, tongue, or throat. If these symptoms occur, the antibiotic should be immediately stopped, and you should get emergency medical attention. Allergic reactions can occur with any antibiotic.Antibiotics are also associated with diarrhea that can be watery, bloody, and severe. This type of diarrhea is often referred to as antibiotic-associated diarrhea or C. difficile colitis, and can occur during or after antibiotic treatment—even several months after the antibiotic treatment is complete. While antibiotic-associated diarrhea can occur with any antibiotic, clindamycin is one of the antibiotics that is sometimes linked to this condition. This diarrhea can be serious and life-threatening, so if you experience diarrhea, call your doctor right away or get emergency medical help.
When is surgery required for tonsillitis?
- Surgical removal of the tonsils: A tonsillectomy is a surgical removal of the tonsils. A tonsillectomy may be required in children who have:
- Tonsillitis 7 times in one year; or
- Tonsillitis 5 times a year for 2 consecutive years; or
- Tonsillitis 3 times a year for 3 consecutive years
- Surgery to drain a peritonsillar abscess: Patients who develop a complication called a peritonsillar abscess (a collection of pus that forms around the tonsil) will need surgery to drain the abscess.
What is the best home remedy for tonsillitis?
If you have a viral infection, you’ll want to try some of these tips. If you have a bacterial infection, you can try these tips, but be sure to take your antibiotic too—for the fully prescribed length of time.Relieving symptoms
To relieve tonsillitis symptoms, you can:- Take OTC medications like Motrin (ibuprofen) or Tylenol (acetaminophen). Children under 18 years old should not take aspirin.
- Stay hydrated by drinking lots of fluids.
- Eat soft foods if swallowing is difficult or painful. You can try warm liquids like soup and/or cold foods like ice cream for a soothing effect.
- Gargle with warm salt water.
- Suck on throat lozenges (only for adults and children 4 years and older; very young children under 4 years old should not have lozenges due to choking risk)
- Get plenty of rest and quality sleep.
- Avoid cigarette smoke and other irritants.
- Use a cool-mist humidifier in your room.
Preventing future infections
To lower the risk of future infections, try these tips:- Wash hands frequently
- Avoid coming into contact with people who are sick
- Do not share food, drinks, towels, or linens with others
Frequently asked questions about tonsillitis
Will tonsillitis go away on its own?
If tonsillitis is viral, it will go away on its own. However, a bacterial infection requires antibiotics to treat the infection and prevent serious complications. Your healthcare provider can take a throat swab to determine if the cause of your symptoms is viral or bacterial—and prescribe an antibiotic if necessary.What is the main cause of tonsillitis?
About 70% of cases of tonsillitis are caused by a virus. Viruses do not respond to antibiotics. People with viral tonsillitis can take OTC pain and fever medication as needed and try other comfort measures until they feel better.What gets rid of tonsillitis quickly?
For a bacterial infection, an antibiotic will help eliminate tonsillitis. You (or your child) may start to feel better in as soon as two days. However, it is important to finish the full course of antibiotics even if you feel better.How long is tonsillitis contagious for?
Inflamed tonsils are not contagious, but the virus or bacteria that cause the infection are contagious. If you have bacterial tonsillitis, you are contagious until you have been on antibiotics for at least 24 hours. You can reduce the chances of getting sick (as well as giving it to others if you are sick) by washing your hands frequently, avoiding contact with others, and not sharing food, drinks, or utensils with others.Related resources for tonsillitis
- Strep Throat, Sore Throat or Tonsillitis: What’s the Difference?, American Academy of Pediatrics
- Tonsillitis, American Academy of Family Physicians
- Tonsillitis, American Academy of Otolaryngology-Head and Neck Surgery
- Tonsillitis, Cleveland Clinic
- Tonsillitis, Johns Hopkins Medicine
- Tonsillitis, Penn Medicine
- Tonsillitis, Stanford Medicine Children’s Health
- Tonsillitis, StatPearls
- Tonsillitis, U.S. National Library of Medicine MedlinePlus