Effective Treatment for Infected Tonsils (Acute Tonsillitis): Symptoms and Relief

Management by Etiology

• Viral (most common): Supportive care only.
• Bacterial (Group A Strep ~15–30%): Antibiotics (penicillin/amoxicillin 10 days; alternatives for allergy).

Symptomatic Relief (All Cases)

1. Analgesics/Antipyretics: Acetaminophen, ibuprofen.
2. Hydration: Cool/warm fluids; avoid citrus, carbonation.
3. Saltwater Gargle: ½ tsp salt in 8 oz warm water, q2–3h.
4. Throat Lozenges/Sprays: Benzocaine, menthol, honey-based.
5. Honey: 1–2 tsp (age >1 yr); antimicrobial, soothing.
6. Humidified Air / Steam: Reduces dryness irritation.
7. Rest: Voice rest; adequate sleep.
8. Soft/Cold Diet: Yogurt, smoothies, ice cream, scrambled eggs.
9. Avoid Irritants: Smoke, alcohol, spicy foods.

Surgical Indication (Tonsillectomy)

Paradise criteria: ≥7 episodes/yr, ≥5/yr ×2 yrs, ≥3/yr ×3 yrs; or peritonsillar abscess, obstruction, malignancy suspicion.

Red Flags (Urgent Evaluation)

• Drooling, stridor, tripod positioning (airway compromise).
• Trismus (inability to open mouth).
• Unilateral swelling displacing uvula (peritonsillar abscess).
• Dehydration, sepsis signs.