Infections
Medicines for Tonsillitis
Inflammation of the tonsils causing a sore throat, painful swallowing, fever and swollen neck glands — usually caused by a virus and settling on its own with pain relief and fluids, but sometimes bacterial, when a course of antibiotics may be needed.
Education and reference only. This explains which medicines are used and why, in plain language — it deliberately contains no doses and is not a substitute for advice from your doctor or pharmacist. Always discuss your own treatment with a qualified clinician, and check the BNF and the product labelling for prescribing detail.
Quick answer
What is Tonsillitis?
Tonsillitis is inflammation of the tonsils, the two soft lumps of tissue at the back of the throat that form part of the body's defences against infection. It causes a sore throat that is often worse on swallowing, a high temperature, swollen and tender glands in the neck, and sometimes white spots or patches of pus on the tonsils, bad breath and a muffled voice.
- How it is treated: Because most tonsillitis is viral and self-limiting, the mainstay of treatment is easing symptoms while the body clears the infection — rest, plenty of fluids, and simple pain-and-fever relief with paracetamol or ibuprofen to soothe the sore throat and bring down a temperature.
- Self-care: Resting, drinking plenty of fluids to stay hydrated, and soothing the throat with warm or cool drinks help comfort while the infection settles.
- When to seek help: Most tonsillitis settles within about a week with rest, fluids and pain relief, but some signs need prompt or urgent attention.
What it is
Tonsillitis is inflammation of the tonsils, the two soft lumps of tissue at the back of the throat that form part of the body's defences against infection. It causes a sore throat that is often worse on swallowing, a high temperature, swollen and tender glands in the neck, and sometimes white spots or patches of pus on the tonsils, bad breath and a muffled voice. It is most common in children but can affect people of any age. The majority of cases are caused by viruses — the same ones that cause colds and other respiratory infections — and these settle on their own within about a week. A proportion of cases, however, are caused by bacteria, most often a type called group A streptococcus, which can cause a more clearly bacterial picture. It is not always possible to tell viral from bacterial tonsillitis on symptoms alone, so doctors use scoring tools that weigh up features such as fever, the appearance of the tonsils, swollen glands and the absence of a cough to judge how likely a bacterial cause is. Tonsillitis can recur, and frequent severe episodes are sometimes a reason to consider removing the tonsils.
How it is treated
Because most tonsillitis is viral and self-limiting, the mainstay of treatment is easing symptoms while the body clears the infection — rest, plenty of fluids, and simple pain-and-fever relief with paracetamol or ibuprofen to soothe the sore throat and bring down a temperature. Soothing measures such as warm or cool drinks and throat lozenges can help an adult comfort the throat. Antibiotics are not used for every sore throat; they are reserved for cases where a bacterial cause is likely or the person is particularly unwell or at risk. Doctors use scoring tools to judge the probability of a bacterial infection and decide whether antibiotics are warranted. When they are needed, penicillin (phenoxymethylpenicillin) is the usual first choice, with a macrolide antibiotic used instead for people who are allergic to penicillin. One important caution: amoxicillin is avoided where glandular fever could be the cause of the sore throat, because it commonly triggers a widespread rash in that infection. Recurrent, frequent and severe tonsillitis may prompt referral to consider surgery to remove the tonsils.
For this condition, these medicines
Medicine classes used for Tonsillitis
Each links to a full, dose-free guide — what it is, how it works, who can and cannot use it, side effects, interactions and FAQs.
Symptom checker
Symptoms that can point to Tonsillitis
Tonsillitis can be one cause of these symptoms. Each guide explains the other possible causes and the red-flag warning signs that mean you should get urgent help:
Beyond medication
Lifestyle and self-care
Resting, drinking plenty of fluids to stay hydrated, and soothing the throat with warm or cool drinks help comfort while the infection settles. Staying off work or school until the fever has passed reduces spreading the infection, and good hand hygiene helps limit its spread to others.
When to get help
When to see a doctor
Most tonsillitis settles within about a week with rest, fluids and pain relief, but some signs need prompt or urgent attention. Seek urgent help — call 999 or go to A&E — if you have difficulty breathing, are drooling because you cannot swallow, cannot swallow at all, find it hard to open your mouth, or develop severe swelling on one side of the throat, which can signal a collection of pus behind the tonsil (a quinsy, or peritonsillar abscess). See your GP or pharmacist if symptoms are severe or are not improving after several days, if you have a very high fever, if you keep getting tonsillitis, or if you are unwell and at higher risk so that the need for antibiotics can be assessed. A child who is much less responsive than usual, is breathing rapidly, or is not drinking should be assessed quickly.
Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.
Answers
Tonsillitis: frequently asked questions
What medicines are used for tonsillitis?
Most tonsillitis is caused by a virus and gets better on its own, so the usual treatment is simple pain-and-fever relief with paracetamol or ibuprofen, along with rest and plenty of fluids. Antibiotics are not used for every sore throat — they are reserved for cases where a bacterial cause is likely or the person is particularly unwell or at risk, judged using scoring tools. When antibiotics are needed, penicillin (phenoxymethylpenicillin) is the usual first choice, with a macrolide antibiotic used for people allergic to penicillin. Amoxicillin is avoided where glandular fever could be the cause, because it commonly triggers a rash in that infection.
Is tonsillitis viral or bacterial?
It can be either. Most cases are caused by viruses — the same ones behind colds and other respiratory infections — and these clear up on their own without antibiotics. A proportion of cases are bacterial, most often due to group A streptococcus. It is not always possible to tell the two apart from symptoms alone, which is why doctors use scoring tools that weigh up features such as fever, the look of the tonsils, swollen neck glands and the absence of a cough to estimate how likely a bacterial cause is. This helps decide whether antibiotics are appropriate, so they are used when they are genuinely likely to help rather than for every sore throat.
When are antibiotics needed for tonsillitis?
Because most tonsillitis is viral and self-limiting, antibiotics are not given routinely. They are considered when a bacterial cause is likely — based on scoring tools that assess features such as fever, the appearance of the tonsils and swollen glands — or when the person is particularly unwell or at higher risk of complications. Used in the right cases, antibiotics can speed recovery and reduce the small risk of complications; used unnecessarily, they bring side effects and contribute to antibiotic resistance without benefit. Penicillin is the usual first choice, with a macrolide for those allergic to penicillin. A doctor or pharmacist can advise whether antibiotics are right for you.
What is quinsy and when should I worry?
A quinsy, also called a peritonsillar abscess, is a collection of pus that forms beside a tonsil, usually as a complication of tonsillitis. It tends to cause severe, often one-sided throat pain, increasing difficulty and pain on swallowing, difficulty opening the mouth, a muffled "hot potato" voice and severe swelling on one side of the throat. It is a medical emergency that needs urgent assessment and drainage, so you should seek urgent care — call 999 or go to A&E — if you have these features, especially if you are also struggling to breathe, drooling because you cannot swallow, or cannot swallow at all. Prompt treatment relieves the abscess and prevents it spreading.
Keep reading
Related articles
Sources
Where this is drawn from
- NICE CKS: Sore throat - acute (tonsillitis).
- UK Health Security Agency: Group A streptococcal infections.
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