When is antibiotic treatment recommended for tonsillitis?

Tonsillitis can be caused by viruses or bacteria, and antibiotics do not treat viral infections. A clinician may assess your throat, tonsils, fever, swollen neck glands, cough and general condition before deciding. A throat swab or other test may be used when it would clarify the cause. The choice also depends on allergies, previous reactions, other medicines and whether there are signs of a complication such as an abscess beside a tonsil.

Arrange a medical assessment if severe throat pain, fever, pus on the tonsils or difficulty swallowing is not settling. Until reviewed, drink fluids, choose soft foods, rest and use a suitable pain or fever medicine only as directed on its label or by a clinician. If antibiotics are prescribed, take them exactly as instructed and do not share leftover doses. Contact the prescriber if a rash, breathing problem or other unexpected reaction develops.

Seek urgent medical help for trouble breathing, inability to swallow saliva, rapidly increasing swelling, a muffled voice, difficulty opening the mouth, marked dehydration or severe weakness. These features can signal airway difficulty or a tonsil-area complication and need prompt examination, regardless of whether the cause is viral or bacterial.

Ask whether the findings suggest a bacterial infection, whether testing is useful, how to manage pain and fluids, and which warning signs should prompt reassessment. If an antibiotic is offered, ask how to take it, what side effects to watch for and what to do if a dose is missed.