You may need antibiotics for tonsillitis when a bacterial infection is likely and you have been advised by a doctor or healthcare professional. Importantly, most cases of tonsillitis are caused by viruses, which antibiotics cannot treat.
Your symptoms, medical history and risk of complications help determine whether antibiotics are necessary. Taking them when they are not needed can cause side effects and contribute to antibiotic resistance.
Throat Specialist is founded by Dr Nick Hamilton who specialises in chronic tonsillitis treatment in London and other chronic conditions relating to the throat, tonsils and voice. To discuss your symptoms, please contact us on secretary@throatspecialist.co.uk or call us on 020 7034 6053
Key takeaways:
- Antibiotics treat certain bacterial infections but do not work against viruses.
- A clinician can assess whether antibiotics are appropriate for your symptoms.
- Repeated tonsillitis may require further assessment rather than repeated courses of antibiotics.
How can antibiotics help with tonsillitis?
Antibiotics can help treat tonsillitis caused by susceptible bacteria by killing the bacteria or stopping them from multiplying.
They may be prescribed when your symptoms and clinical assessment suggest a bacterial infection that is likely to benefit from treatment. Antibiotics may also be appropriate if you are particularly unwell or at increased risk of complications.
Read our guide on: What is the difference between viral and bacterial tonsillitis.
However, antibiotics do not provide immediate relief, and they are not necessary for every bacterial sore throat. Some bacterial infections improve without them, and the benefits of treatment depend on the circumstances.
If antibiotics are prescribed, follow your clinician’s instructions and the information supplied with your medicine. Do not share antibiotics with anyone else or use leftover tablets from a previous illness.
If your symptoms worsen significantly or you do not begin to improve as expected, seek further medical advice. Severe pain, difficulty swallowing or signs of an abscess may require urgent assessment.
Which antibiotics might be prescribed to treat tonsillitis?
- Phenoxymethylpenicillin (Penicillin V)
- Clarithromycin
- Erythromycin
Antibiotic courses usually run for 5 to 10 days (Source: NICE).
Why should you not use antibiotics for tonsillitis unnecessarily?
You should not use antibiotics unnecessarily for tonsillitis because they are ineffective against viruses and may expose you to side effects without providing a meaningful benefit.
Viral infections are the most common cause of tonsillitis. Taking antibiotics for a viral infection will not clear the virus or directly relieve the inflammation.
NICE guidance states that acute sore throats, including tonsillitis, usually improve within about one week, regardless of whether the cause is viral or bacterial. Treatment decisions should therefore consider the likely cause and the risk of complications rather than symptoms alone.
Unnecessary antibiotic use also contributes to antimicrobial resistance. This occurs when bacteria become resistant to medicines that would previously have treated them, making some infections harder to manage in the future.
What is the risk of using antibiotics if you do not need them?
The risks of unnecessary antibiotics include diarrhoea, nausea, stomach discomfort, allergic reactions and contributing to antibiotic resistance.
Some people experience mild side effects, while others may develop more serious reactions. Antibiotics can also interact with other medicines, so tell your clinician or pharmacist about any medication you take.
Taking antibiotics when they are not needed may also create false reassurance if your symptoms are caused by another condition that requires different treatment.
Never use antibiotics prescribed for another person. If you have already started a prescribed course and are concerned about side effects, contact your healthcare professional for advice rather than changing your treatment independently.
What other remedies can help with tonsillitis?
The most useful remedies for tonsillitis include rest, regular fluids, suitable pain relief and foods that are comfortable to swallow.
Cool drinks may soothe your throat, while soft foods can make eating less painful. Paracetamol or ibuprofen may help relieve pain and fever if these medicines are suitable for you. Follow the packet instructions and seek advice if you are unsure.
Adults and older children who can gargle safely may find warm salt water soothing. Avoid smoking and try to rest while you recover.
Most episodes improve within about a week. If your symptoms are not improving, you repeatedly develop tonsillitis or you find it difficult to eat and drink, seek medical advice.
What should I do if I think I have chronic tonsillitis?
If you think you have chronic or recurrent tonsillitis, arrange an appointment with your GP to discuss how often your symptoms occur and how they affect your daily life.
Record the dates of your episodes, how long they last, whether you develop a fever and whether you have needed medical treatment. Your GP can assess whether the episodes are consistent with tonsillitis and whether further investigation or an ENT referral is appropriate.
Repeated infections do not automatically mean you need antibiotics every time. Depending on the circumstances, an ENT specialist may discuss other treatment options for severe, recurring episodes.
Read more about why do I keep getting tonsillitis to understand when specialist assessment may help.
If you develop severe or rapidly worsening pain, swelling in your mouth or throat, difficulty opening your mouth or an inability to swallow, seek emergency medical assessment. Call 999 or attend A&E if you have difficulty breathing or cannot swallow saliva.
