Tonsillitis (being treated with antibiotics)

Advice intended for parents/carers taking their child home after seeing a hospital based healthcare professional

Tonsillitis is inflammation of the tonsils. It is usually caused by a viral infection, or less commonly, a bacterial infection.

Tonsils are small glands that sit either side of the throat. They help to prevent infection spreading further into the body. Tonsillitis is common in children, teenagers and young adults.

Symptoms

  • Sore throat and pain on swallowing
  • Fever can be present
  • Swollen, painful lymph nodes in your neck
  • Your child might not be drinking as much fluid as normal

These symptoms usually pass within 4-7 days.

Causes

Most cases of tonsillitis are caused by a viral infection, if this is the case your child is likely to also have a runny nose, cough or earache. Bacterial tonsillitis can be caused by a number of different bacteria, but it is usually due to group A streptococcus bacteria (strep throat).

Treatment

Most children with tonsillitis do not need antibiotics. If your child has confirmed group A streptococcus or certain symptoms, then you may be prescribed up to 10 days of oral antibiotics.

You can help relieve symptoms by:

  • Giving your child paracetamol or ibuprofen to help relieve pain
  • Encourage your child to drink plenty of fluids
  • Soft food such as ice cream and yoghurts might be easier to swallow

Treatment with intravenous antibiotics (given into a vein) is usually only needed for severe cases or those that have not responded to antibiotics given by mouth.

Some children who need intravenous antibiotics are admitted to hospital initially whilst others can be looked after at home. These children would come into hospital once a day for someone to look at them and for their antibiotics to be given.

The decision on when to change from intravenous to oral antibiotics (tablets or liquid) will be made by the medical team caring for your child. This will depend on how quickly your child responds to treatment (improvement in fever, pain and sometimes their blood tests) and whether your child has other health conditions.

Antibiotics are usually given up to a total of 10 days. You can give regular pain relief (Paracetamol or Ibuprofen) until any discomfort has improved.

Complications

Most children recover without any complications. However, possible complications from tonsillitis include:

  • Quinsy (abscess)
  • Breathing difficulties and sleep disturbances

If you are concerned that your child's condition is getting worse within 48 hours, you should contact your discharging ward or otherwise contact primary care.

Things to look out for include:

  • Fever
  • Fast heat beat
  • Fast breathing
  • Changes in behaviour, such as confusions or disorientation
  • Increase in pain

Call 999 for an ambulance if you have serious concerns for your child.

Prevention

It is not always easy to avoid catching these infections. However, good hygiene practices can prevent infections spreading.

  • Wash your hands frequently
  • Use a tissue when coughing or sneezing and put it in the bin
  • Avoid sharing glasses or utensils with people who are unwell