Treatment of tonsillitis: medication (when antibiotics?) and topical + surgery

The correct treatment of angina must always be preceded by a correct diagnosis. The diagnosis must first of all distinguish whether the angina is viral or bacterial.

The main aim of treating angina is to alleviate or completely eliminate the symptoms and prevent complications.

1. Viral angina

Angina caused by a viral pathogen will resolve itself after a few days. Its treatment consists mainly of supportive measures that alleviate the symptoms and the course of the angina itself.

Supportive measures include rest, plenty of fluids, sweating, sufficient humidity in the room where the patient is staying and vitamin supplementation.

In some cases, it is beneficial for the patient to eat a soft, mushy diet that does not cause pain when swallowing. Eating hot or cold foods and drinks can also provide relief.

It is advisable to avoid smoking. Smoking can excessively irritate the throat.

Rinsing the throat with salt water or disinfectant mouthwashes may also be helpful. Gargles containing sage, thyme or chamomile may be a natural alternative.

Viral tonsillitis is not treated with medicines that act directly on the viral pathogen. Medicines are used only as supportive treatment to relieve the symptoms of tonsillitis.

Analgesics may be used to relieve pain, antipyretics to relieve fever, sucking lozenges containing analgesics or local anaesthetics, and in some cases non-steroidal anti-inflammatory drugs.

In more severe cases where swelling of the tonsils causes breathing problems, the use of corticosteroids is also indicated.

2. Bacterial tonsillitis

Tonsillitis caused by a bacterial pathogen is usually treated with antibiotics.

Antibiotics help to speed up the recovery time, reduce the risk of complications and shorten the time the patient is infectious to others.

The drugs of first choice are usually penicillins. They are administered orally, sometimes parenterally. Treatment takes approximately 7-10 days.

If treatment with penicillins does not work after 3-4 days, if the patient is allergic to penicillins, or if the bacteria has a low sensitivity to the antibiotic, substitution with another antibiotic is necessary.

Cephalosporins, macrolides, lincosamides or amoxicillin can be used.

Treatment with penicillins for recurrent tonsillitis usually fails.

When treating with antibiotics, the basic rules should always be followed.

The doctor must consider all the risks when deciding whether an antibiotic is necessary. This includes, for example, the fact that many of the bacteria that cause tonsillitis are also a natural part of the microflora of the mouth and throat.

They must take into account the increasing rate of development of antibiotic resistance and the side effects of antibiotics.

The patient must approach treatment responsibly and not interrupt treatment without consulting a doctor. He must not interrupt treatment even if the symptoms of angina are subsiding.

Of course, even in the case of bacterial angina, the supportive measures mentioned in the treatment of viral angina can be used.

Surgical treatment is also sometimes used in the treatment of angina.

This treatment consists of the surgical removal of the entire tonsil. It is called tonsillectomy.

Tonsillectomy is usually performed in the following cases:

• In chronic forms of tonsillitis
• Recurrent tonsillitis
• If the patient is at risk of developing serious complications (e.g. rheumatic fever)
• If inflamed and swollen tonsils cause breathing or eating problems
• If the patient is allergic to certain antibiotics
• If the patient has regular attacks of pharyngitis

Surgical removal of tonsils can be done regardless of age.

A complication of the procedure may be bleeding as part of the wound healing process. It may occur approximately 14 days after the procedure. Another complication of the procedure may be weight loss (the patient has difficulty eating).

Sometimes a surgical procedure called tonsilotomy is also used, in which only part of the tonsil tissue is removed, especially in children.

3. Angina in pregnancy

The symptoms and course of tonsillitis in pregnant women do not differ significantly compared to other patients.

The presence of tonsillitis in a pregnant woman may pose some risk to the fetus, primarily due to the general weakening of the woman's immune system.

The presence of fever, the systemic spread of infection from the site of infection to the body and the associated development of complications (kidney inflammation, rheumatic fever, etc.) can be dangerous.

The treatment of angina in pregnant women consists primarily of supportive measures.

If medicines are needed, for example, to reduce fever or relieve pain, the woman should take only those that are not contraindicated in pregnancy.

It is definitely advisable for a pregnant woman to consult her doctor about her health and the need to take any medication.