No antibiotics for infected throat?

[Pimpernella]

Poor DS is on day 3 of severe sore throat with fever so, after a bit of googling, read that if there was white pus it was bacterial and he needed antibiotics.
The paramedic at the surgery said that even though yes there is white stuff they no longer give antibiotics unless he has a temperature or high heart rate.
Is this right and when did it start? Poor DS.
I fear Dr Google may have been american. 😁

My child is 12 and I had the same experience 8 years ago. They prefer to only prescribe antibiotics when absolutely necessary and they will give the body time to fight the infection for itself first.

Dd was diagnosed with tonsillitis yesterday.. What an absolute faff.
GP no appointments.
Rang 111 after phone assessment - sent to pharmacy for face to face..
Agreed tonsillitis but can't prescribe and also can't book OOH appointments.
Rang 111 back and had to have another phone assessment.
Agreed needs to be seen but offers a GP phone appointment with a practice nearby.. (wtf?)
Eventually offers an OOH appointment..
Tonsillitis diagnosed immediately..
Chemist said waiting time was half an hour.
4 hours later have a prescription.
School ring and suggest she takes 2 paracetamol and go into school!
I need some myself after yesterday!

If your child has no underlying health issues and if they are comfortable, just let their body do the job 😉 I know you want to help but antibiotics can create a lower immunity (temporarily) and other issues. Best to avoid medication (even fever lowering ones!!!) unless the person/child is very uncomfortable/can't sleep/can't function properly

If she has bacterial tonsillitis she does need antibiotics, otherwise it can lead to the bacteria settling in the heart and causing heart valve damage. Its called rheumatic heart disease. I would go back and ask/insist

Interesting.
I know he had antibiotics for it a couple of times sooner than 8 years ago.
I know its better to avoid antibiotics but he is so poorly. 😕
also read he could be infectious for as long as a month without abs but not infectious after 24 hours with.

most illnesses are self limiting.
they go away on their own after a while.
even most bacterial infections.

paracetamol for the pain. strepsil (or similar own brand) losenges help as well.

all the best.

It’s been like this for over 15 years. Pus is one of the Centor criteria but for kids you need to hit three of them for it to be more likely bacterial than viral. DS used to always have absence of cough and a raging high temp along with pus www.nice.org.uk/guidance/ng84/chapter/terms-used-in-the-guideline

so if the only one of the criteria hit was pus then it wouldn’t meet the prescribing criteria for antibiotics.

disclaimer - not a doctor but had a DS who was a martyr to his tonsils and got very familiar with the guidelines over 15 years ago and looks like they are still the same ones

Antibiotics have been shown to reduce the length of illness in sore throat by less than 1 day which is not exactly brilliant.

In deciding to give antibiotics pus is only one of the factors, the paramedic was correct as they use a scoring system to decide.

Sorry just re read your post. You say he had a temperature but then you say they won’t prescribe unless there is a fever (which along with absence of cough and tenderness are the other criteria) so a bit confused about if he did or didn’t have a fever.

take a look at the Centor criteria and if he fits them then maybe call back. Otherwise it is most probably viral and should get better soon

GPs are more likely to hand out gold bars than antibiotics these days.

DS had an eye infection which went absolutely nuclear and my twat of a GP wanted to wait 7 days before treating it. I had to escalate and complain and shout and threaten to get the antibiotics, which worked, obviously.

It’s just typical NHS crap service and endangering children to save money but yanno #thankyounhs

Fair enough.

Though I think he'd be very happy with one day less pain. He is struggling to sleep at night.

Out of interest - if he hadn't had paracetamol - would he have then presented with a temperature? He says he is hot and cold through the night when he hasn't had any.

What’s his temp before you gave him paracetamol and after. With DS he’d be hitting 39.8 and it would drop to low 38s high 37s when the paracetamol kicked in (he never had febrile convulsions though. One gp described him as a “happy cooker” 🤣)

It is miserable when they are ill. If he does meet the criteria then definitely call GP back

You can buy a spray over the counter which is amazing. Difflam spray it's called.
It will take the edge off it for him.

Day 5 now and he vomited this morning. Throat still very sore.
Thanks about the spray but he hated it! 😁
No actual temperature but says he was throwing the duvet on and off all night again.
Would you take him back? I always feel a bit told off when they send you away.
Feel a bit silly posting about a sore throat but he is so miserable. (strapping teenager by the way - I suspect I wouldn't be asking if he was little. )

Not sure your interpretation of Dr Google is correct.
It is possible for a bacterial infection to cause problem in the heart but it’s much more complex and extremely rare.
If OPs child was at risk she would have been made aware of this by her child’s cardiologist.

OP try some topical treatments first. I discovered some years ago that gargling with hydrogen peroxide based mouthwash was very effective at relieving symptoms. Peroxyl by Colgate is a staple in our house.
Salt water is an alternative but doesn’t taste very nice.

You be never had antibiotics- despite always having ulcerated tonsils. They usually aren't really needed. Much like antibiotics for ear infections for most kids.

He absolutely needs antibiotics

Gargling with salt water 3x a day is really effective plus keep up with pain killers regularly. Poor boy,sounds rotten.

Sounds like pharyngitis which I've had and is unbearably painful and requires antibiotics

Swollen throat, pus and a fever

I was hospitalised the first time I had this as I couldn't swallow so was very dehydrated

It is not better to avoid antibiotics for something that will respond very quickly to and requires antibiotics

The fever is the red flag 🚩 that antibiotics are required asap in this case

I'm confused now though.
I always thought being hot and cold meant you had a fever. But he doesn't have an actual temperature. (though thermometer battery a bit dodgy - might need to try the meat thermometer🙄) Are they not the same thing?
I'm remembering being sooo ill with swine flu. Furiously hot then teeth chattering and I didn't have a temperature when the GP checked.

Not giving out antibiotics is not a money saving activity. There is a huge problem with antibiotic resistance, and it's going to be one of the biggest killers on the planet unless action is taken to stop irresponsible prescribing of antimicrobials.

My second dd now has tonsillitis.. 4 calls to 111. I from a Dr. 1 from the appointment dept. An appointment at OOH at 9.30 last night.
Made the first call to 111 at 2.40 who said she needed it see a Dr within 2 hours...

OP I have suffered from tonsillitis every year since I was a child. I was always prescribed antibiotics as the infection was thought to be bacterial. A few years ago I was advised that the surgery guidance had changed and that they no longer gave antibiotics for 'routine' tonsillitis. I was confused, but took their advice (antibiotics are bloody horrible and I hate taking them) However, I needed them. Long story short I was hospitalised a week later with quinsy (a life threatening tonsil abscess as a result of untreated tonsillitis) and was in hospital for 3 days, and on a cocktail of drugs for 6 weeks after.

Needless to say when I get tonsillitis now, they throw drugs at me.

Keep a very close eye on your boy. If he complains of earache, or cannot swallow saliva or open his mouth, or his voice changes, get medical advise ASAP x