Tonsillitis (being treated with antibiotics)

Advice intended for parents/carers taking their child home after seeing a  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.


  • Sore throat and pain on swallowing
  • Fever can be present
  • Swollen, painful lymph nodes in your neck

These symptoms usually pass within 4-7 days.


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).

If your child has any of the following:

  • Has blue lips
  • Becomes pale, mottled and feels abnormally cold to touch
  • Severe breathing difficulty - too breathless to talk/eat or drink
  • Has a fit/seizure
  • Becomes extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake)

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

  • Is unable to swallow their own saliva
  • Is having difficulty opening their mouth
  • Develops twisting of their neck to one side (torticollis)
  • Is having breathing problems, such as rapid breathing, shortness of breath or laboured breathing (drawing in of muscles below the lower ribs when they breathe in)
  •  If they start making unusual sounds when they breathe in or out (stridor).
  • Seems dehydrated (sunken eyes, drowsy or no urine passed for 12 hours)
  • Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) - especially if they remain drowsy or irritable despite their fever coming down
  • Has extreme shivering or complains of muscle pain
  • Continues to have a fever of 38.0°C or above for more than 5 days
  • Is getting worse or if you are worried

You need to contact the discharging ward urgently

If none of the above features are present


Continue providing your child’s care at home. If you are still concerned about your child, contact NHS 111 – dial 111 or for children aged 5 years and above visit


Most children with tonsillitis do not need antibiotics. If your child has confirmed group A streptococcus or certain symptoms, then you may be prescribed 7 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

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 for a total of 7 days. You can give regular pain relief (Paracetamol or Ibuprofen) until any discomfort has improved.


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 (see table above), your should contact your discharging ward.

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


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


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