Antibiotics for tonsillitis

Antibiotics only work on bacteria. If the tonsillitis is viral, there is no causal treatment option! In case of a bacterial cause – recognizable by the purulent coatings – antibiotics are prescribed by the family doctor for therapy.

Penicillin is very effective. Alternatively, cephalosporins can be considered for the treatment of tonsillitis. With allergies against these antibiotics macrolides such as Clarithromycin are prescribed for treatment.

The antibiotics are prescribed for at least 7 days, usually even for 10 to 14 days. It is important to take the antibiotic always until the end of the prescription through – even if the symptoms already subside much faster – because bacteria still remain in the depths of the tonsils and can quickly lead to an acute inflammation again. Thus a renewed treatment with antibiotics would be necessary.

For patients with immune deficiency (HIV, cancer, chemotherapy, congenital immune defects and others), the doctor will use one antibiotic or even a combination of several at an earlier stage. For these patients, even the most trivial tonsillitis can become threatening due to complications! In the case of a single acute tonsillitis, surgery is out of the question.

However, if a patient suffers from chronic purulent tonsillitis that occurs more than three times a year, a tonsillectomy is performed for treatment. This is the surgical removal of the palatine tonsils by the ear, nose and throat specialist. When is the tonsillectomy performed?

In general, children under 4 years of age are not treated with an operation, as the palatine tonsils are still needed to fight off pathogens. Tonsillectomy in children under the age of four should only be performed in an extreme emergency. At a later stage, the palatine tonsils hardly have any defense function and can be removed without consequences for the immune system.

Chronic tonsillitis with symptoms such as bad breath or difficulty swallowing
Acute tonsillitis occurring more than 3 times a year
Non-healing or recurrent peritonsillar abscess
Sepsis (blood poisoning) after tonsillitis
Unilaterally enlarged palatal tonsil to exclude a malignant tumor
Palatal tonsil as a bacterial focus in immunocompromised patients with HIV, cancer, chemotherapy, etc.
Highly enlarged tonsils, which lead to snoring and a mechanical obstacle
No surgery for leukemia (blood cancer), polio epidemics or if the white blood cells are completely absent

The tonsillectomy is performed by the ear, nose and throat specialist. The patient is put under general anesthesia and is given a breathing tube so that he or she does not swallow blood during the operation. In adults, the operation can also be performed under local anesthesia.

The head is stretched backwards. Then the anterior palatal arch is incised about one centimeter and the palatal tonsil is peeled out of its bed with a sharp spoon. The lower pole is tied off with a noose.

What are the risks of tonsillectomy? The most frequent complication is post-bleeding. This can occur either directly on the day of the operation, when the vasoconstricting anesthetic drugs are no longer effective.

However, since the patient is still in hospital, the bleeding can usually be stopped quickly. Late post-operative bleeding is more risky. This usually takes place 6 to 7 days after the operation, when the scab falls off.

Due to this complication, the duration of the hospital stay is therefore about one week. To reduce the risk of postoperative bleeding, strict physical protection after tonsillectomy is absolutely necessary! What is the prognosis after tonsillectomy?

The symptoms are usually completely eliminated by tonsillectomy. Only rarely is an increased occurrence of pharyngitis described. Tonsillectomy is the partial removal of the palatal tonsils.

Since children, especially under four years of age, are still in an immunological learning phase, they need their palatine tonsils to defend themselves against pathogens. Especially in children, however, tonsillitis is a frequent and often recurrent occurrence. If the tonsils become larger in the course of this and lead to an obstruction in breathing, swallowing or to heavy nightly snoring, treatment becomes necessary.Instead of a complete removal of the tonsils, a partial removal, the tonsillotomy, can be performed.

This leads to a reduction in the size of the palatine tonsils, but leaves a residue that can adequately defend against infection. The advantage of this treatment is that the tonsillotomy can also be performed on an outpatient basis with a laser. It leads much less often to secondary bleeding.

The disadvantage of this therapy is that it more often leads to chronic tonsillitis and scarring of the tonsils. This slightly increases the risk of an abscess. In summary, tonsillectomy represents an alternative treatment option to tonsillectomy, which is mainly used in young children.

Unfortunately, there is no vaccine against the most common pathogens of tonsillitis, streptococci. However, there are vaccinations against pneumococci and haemophilus influenzae. These are administered to children by their pediatrician while they are still babies, because in addition to tonsillitis they can cause much more dangerous diseases such as meningitis and pneumonia.

The pneumococcal vaccine is also administered to adults over the age of 60 and those with chronic diseases such as diabetes, heart disease, lung or liver disease. You can find out what else helps with tonsillitis under our topic: Tonsillitis what helps? On this page you will find helpful information about the following areas:

Home remedy for tonsillitis
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