Medicines and treatments for tonsillitis
Tonsillitis will often get better by itself, as the body's immune system can usually take care of the infection without any treatment, so antibiotics are not recommended for most people.
There are some simple but effective ways you can relieve your symptoms, as well as taking over-the-counter medicines for pain and fever.
What can I do to relieve my symptoms?
You should try to:
- drink plenty of water and non-alcoholic fluids
- avoid smoking and exposure to cigarette smoke
- inhale steam; this can help relieve a blocked nose. Supervise your child while they breathe in steam from a hot bath or shower in a closed room.
- gargling with warm salty water
- sucking on an ice cube or a throat lozenge
- drinking hot water with honey and lemon; this can also be a simple and effective home remedy.
Medicines for relieving pain and fever
There are medicines you can take to help manage the symptoms of tonsillitis. These include paracetamol, ibuprofen and aspirin.
- Adults and children older than 1 month can take paracetamol.
- Adults and children older than 3 months can take ibuprofen.
- The dose of paracetamol or ibuprofen for children is worked out according to how much your child weighs. Read more about measuring and administering a child’s dose of medicine.
- Some people may not be able to take paracetamol or ibuprofen.
- Do not give aspirin for pain or fever to children younger than 12 years as it may cause serious side effects.
- Do not give aspirin for fever to children between 12 and 16 years. This is because Reye’s syndrome, which can affect brain function and cause liver damage, has been associated with aspirin use in children (this is rare)*.
Fevers are common in young children, especially if they have a respiratory tract infection or after a vaccination. A fever (a temperature of 38.5°C or higher) doesn’t necessarily mean your child has a serious illness. In fact, a fever helps the body's immune system to fight infection. Find out more about how to treat a fever.
*Rare: fewer than 1 in 1000 people will experience the side effect.
Tips for using pain and fever medicines safely
- Paracetamol and ibuprofen are also a common ingredient in some cold and flu medicines, so it is important to check the active ingredients on the label of your medicine to avoid 'doubling up' and taking other medicines that also contain paracetamol.
- It is important that you tell your health professional about all the medicines you or anyone in your care is taking — including prescription, over-the-counter and complementary medicines (herbal, 'natural', vitamin or mineral supplements). This is because all medicines, including herbal and natural medicines, can cause side effects and may interact with other medicines.
- Some medicines cannot be taken by people with particular medical conditions, by people who are also taking certain other medicines, by young children, during pregnancy or when breastfeeding.
Phone for medicines information
Call NPS Medicines Line on 1300 MEDICINE (1300 633 424) to get information about your prescription, over-the-counter and complementary medicines (herbal, ‘natural’, vitamins and mineral supplements) from a pharmacist. Your call will be answered by healthdirect Australia (except Queensland and Victoria).
Note about medicines names
Most medicines have two names: the active ingredient and the brand name. The active ingredient is the chemical in the medicine that makes it work. The brand name is the name given to the medicine by its manufacturer. There may be several brands that contain the same active ingredient. This website uses active ingredient names (e.g. amoxycillin), with brand names in brackets and with a capital letter (e.g. Amoxil). We also discuss medicines in groups or ‘classes’ when their effects or actions are very similar.
Antibiotics can prevent complications due to bacterial tonsillitis
Tonsillitis can be caused by a virus or by bacteria. Because most people can fight the virus or bacteria on their own, your doctor will usually only prescribe antibiotics if they are concerned about complications including:
- otitis media (middle ear infection)
- an abscess — an infection that produces pus in the tissue around the tonsils (peritonsillar abscess, also known as quinsy)
- glomerulonephritis (which causes inflammation in the kidneys)
- rheumatic fever (a rare condition that occurs after a Streptococcus pyogenes infection and causes inflammation of the heart muscle, joints, skin and brain).
If your infection is caused by bacteria, antibiotics will only shorten your illness by less than 1 day. Antibiotics will only prevent an ear infection in 1 out of 200 people taking antibiotics.
When your doctor thinks an antibiotic will help, the recommended antibiotic is penicillin, or roxithromycin if you or your child are allergic to penicillin.
Antibiotics are recommended to prevent complications in:
- Aboriginal and Torres Strait Islander people aged 2–25 years old who have a sore throat and are living in communities at high risk of rheumatic fever (e.g. in central and northern Australia)
- people with heart problems caused by rheumatic fever
- people with scarlet fever.
Will I need to have my tonsils removed (tonsillectomy)?
Routinely removing the tonsils for recurring tonsillitis is no longer recommended, because:
- tonsillitis will often get better by itself, as the body’s immune system can take care of the infection without any treatment
- you can still have throat infections (pharyngitis) even after your tonsils have been removed
- surgery can have risks such as bleeding and infection.
However, your doctor may consider tonsillectomy for people (especially children) who have:
- recurring bouts of severe tonsillitis
- airway blockage that disturbs sleep (obstructive sleep apnoea), due to enlarged tonsils or adenoids
- an infection that produces pus in the tissue around the tonsils (peritonsillar abscess, also known as quinsy).
- Antibiotic Expert Group. Therapeutic guidelines: Antibiotic; Pharyngitis and/or tonsillitis. Melbourne: Therapeutic Guidelines Ltd; 2012.
- Burton MJ, Glasziou PP. Tonsillectomy or adeno-tonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis. Cochrane Database Syst Rev 2009:(1):CD001802. onlinelibrary.wiley.com/doi/10.1002/14651858.CD001802.pub2/abstract (accessed 15 March 2012).
- Bellussi L, Busoni P, Camaioni A, et al. Appropriateness and safety of tonsillectomy: guidelines. Rome: Italian National Institute of Health, 2008. www.snlg-iss.it/en_lgn_tonsillectomy_2008 (accessed 15 March 2012).
- Rossi S, ed. Australian Medicines Handbook [online]. Adelaide: AMH, July 2012.