Antibiotics for Tonsillitis?

[Ohsofedupwiththis]

DS is quite poorly this weekend with occasional perk up when ibuprofen has well and truly kicked in.

Tonsils covered in white, high fever (been over 38.5 most of day with alternating calpol and nurofen). Calpol not doing a lot. Nurofen giving him a couple of hours relief but he can't have any more until later tonight. Been crying in pain at times with his head and legs feel like jelly. He is not struggling with light etc so I am not worried about anything more serious.

111 passed us over to pharmacist. I was expecting a prescription of Penicillin but nope, it seems he doesn't need it because he is not struggling to breathe and he has eaten (he had a bit of lunch when nurofen kicked in).

He's now back to fever and shivering and in more pain.

He doesn't have a cold or a cough. I do think it's bacterial tonsillitis (not an expert but from my experience with my 2 DC).

Would you go back to 111?

I'm trying not to be a neurotic mum and it's a while since one of my kids have been poorly. But we have always had antibiotics before.

He's been tested for Covid and it's negative.

Just wondering what others would do as this is the 1st time any of my DC has had a fever during the pandemic and its obviously not as easy to access treatment as before.

DS was hospitalised with tonsillitis. It can become serious and isn’t “just a sore throat”. I would call 111 in your situation.

You can give Calpol & Nurofen at the same time, you don't need to alternative it. I'd try this first.

Bit different because I'm an adult but I recently had antibiotics for tonsillitis. See if your practice has a e-consult system.

He sounds very sick OP, I would bring him to a walk in clinic asap

The need for penicillin isn't defined by whether they can breathe/eat, it's based on viral or bacterial infection as you say. How ridiculous of them to say that is the criteria on which the decision is made.

I used to have tonsillitis loads and was always much improved within 24 hrs of starting antibiotics but there were always some sadists who would insist of watching and waiting for a couple of days in case it was viral. It just which just prolonged my misery and meant I ended with quinsy twice which is not fun.

I'd go back, say they're not eating and ask for the ABs, it's not worth enduring the pain just in case.

My Dd and I are both recovering from tonsillitis, both on antibiotics. I would ask for a second opinion. Dd has been ill for 10 days, and I haven't felt this awful since I had pneumonia (granted I am also 8 months pregnant which isn't helping).

Try 111 again and try see doctor.

I have suffered from tonsillitis throughout my life to varying degrees. Usually I say leave it 3-4 days to see if it clears up by itself, but with a child who isn't eating and feeling very poorly I would call 111 again and this time see if you can be connected to an out-of-hours GP.

Also Difflam spray is amazing

@PandoraP

DS was hospitalised with tonsillitis. It can become serious and isn’t “just a sore throat”. I would call 111 in your situation.

Same here and then I was also hospitalised with it a few years later. I'm not a professional but it sounds like it needs antibiotics to me.

Dd3 just finished a course of antibiotics for tonsillitis so i would go back to a walk in clinic

Antibiotics are only given in certain circumstances, not every case of tonsillitis requires them. Many are viral, and even in cases of bacterial tonsillitis there is a general discouragement for giving unless patients fit a certain criteria- evidence suggests antibiotics will shorten the duration of illness by 24 hours or less in many cases so are not advised. Depending on where you are the feverPAIN criteria or censor criteria are used to decide who should and should not be offered antibiotics.

Sorry- centor criteria! Autocorrected to censor.

@ThreeLittleDots

Also Difflam spray is amazing

Came to say this, also dequadin lozenges if you can get to a pharmacy. I used to suffer with tonsillitis every couple of months when I was younger and it always started to clear up within a day of antibiotics. It's horrific and much much more than just a sore throat. If I were you id call 111 and tell them you want antibiotics for him.

Definitely call 111.

YANBU they can't diagnose over the phone and get it right all the time.

Call back.

I have had many bouts of tonsillitis. Then I had quinsy and an emergency tonsillectomy because I was struggling to breath.
Still get it as have scraps of tonsils left.
Never ever have I not been prescribed antibiotics - once it clear what it is.
Symptoms you describe would, if I had them, and there was nothing else significant we don’t know, indicate antibiotics. Not a doctor.

Not every case of tonsillitis - even if it is bacterial- if left untreated is going to end in hospitalisation. Obviously, if you feel he is deteriorating or want a second opinion, that’s fine. But I would highlight that not everyone needs antibiotics- only those with severe cases (feverPAIN of 4-5/5 or centor score of 3 or 4) are advised to be given antibiotics immediately.

Also recommend difflam - I use the gargle. And strefen lozenges - antiseptic and anti inflammatory.

Tonsillitis is a nightmare currently going through another bout with DS.
Boiled 7up works it clears the tonsils IME.
They won't give antibiotics until it hits the chest.
Try the spray.
I can't try anything DS has SN and won't take any medication or allow a doctor look in his mouth.
High temperature hallucinations and vomiting at 4am.

Definately needs an antibiotic.

Fuck, with a few thousand miles distance, I literally can't believe you people put up with this shot some off you are so conditioned to avoid bothering the doctor and avoid the actual meds you need it's ridiculous. Nowhere else with any type of civilisation plays games with lives and wellbeing like this.

DS suffered with frequent tonsillitis (to the point of needing them removed when he was 5). GP was reluctant to prescribe antibiotics and in all honesty, there was very little difference in the recovery time from the times when he had them and when he didn't.
Keep a close eye on him and if you think he's getting worse, then phone back. Keep on top of the pain with paracetamol / ibuprofen and make sure he's getting sufficient fluids (ice lollies are good if he's finding it difficult to swallow).

jacks thanks for that info. So my ‘never ever have I not been prescribed once clear what it is’ should probably have ‘and because it has always been assessed as needing them’ for completeness.

I used to get bacterial tonsillitis a lot. Ive also had quincy when it wasn't treated properly once. Always got penicillin. I tend to find it is only the people who have only experienced viral tonsillitis who expect you to act like a martyr.