Tonsillitis not clearing

[lavenderlou]

DD13 has been unwell for almost two weeks. Started with blocked sinuses and sinus pain then spread to throat. Took her to the GP on Day 5 and was prescribed 5 days antibiotics for bacterial infection. She perked up a bit but her throat was still sore and her tonsils remained very swollen. Took her back to the GP after the course of antibiotics was up as her throat was still so bad. They prescribed 5 more days. We're on day 8 of antibiotics now and there has been no change in her throat at all. Her tonsils are so swollen they almost touch and her neck is all swollen. Ive never known antibiotocs to take so long to work before. At what point would you contact the GP again? She is feeling generally under the weather but no fever.

I tried sending her back to school one day but she felt so much worse after that. She went to the medical room at school but they just told her to have a drink of water. She's now missed almost two weeks of school. We went out for an hour yesterday for an appointment (counselling) and she fell asleep on the way home which is very unusual. Don't know whether to call GP today or wait until antibiotics are finished (Sunday morning).

if it’s a viral infection then antibiotics won’t do anything no matter how much you throw at it.

Viral will get better by itself.

Big questions are:
Is she eating, drinking, peeing and pooing ok?

Has she been having/needing the usual pain relief and anti inflammatory medication for the whole 2 weeks?

GP said bacterial not viral but didn't take a swab. Reduced appetite but drinking as normal. Been taking ibuprofen.

Is she gargling with warm salt water? Does help.

I really sympathise as I've suffered terribly with tonsillitis and it really is awful.

I'd be back at the GP at the end of this course of antibiotics if there is no change asking for a clear plan.

How can the GP tell without a swab if it's viral or bacterial? It's just lazy doctoring, no wonder antibiotics no longer work when they are just dished out without testing first. I'd insist on a swab and if it is bacterial then they need to try a different antibiotic.

I'd make sure she gets lots of rest, don't rush her back to school.

Also, if it recurs, it's worth being aware that tonsils are a reserve site for COVID https://www.medrxiv.org/content/10.1101/2023.01.21.23284592v1

I would go back to GP today and ask for a different antibiotic, fortunately when my DS had tonsillitis as a child antibiotics worked well and quickly if given as soon as symptoms appeared.

Thank you. I'll give them a call and see what they say. I did do a Covid test which was negative but could try another.

are they sure it's tonsillitis not
glandular fever?

To be fair, there is usually a difference in presentation between viral and bacterial.

My sister needed iv antibiotics for a bad case of tonsillitis as a teenager her throat swelled to the point of being unable to swallow antibiotics

When a doctor says "bacterial not viral" or "viral not bacterial". What they are actually saying is "from my experience when a patient presents like this it is usually bacterial in which a cause of antibiotics will help" or "blah blah viral so if I give you antibiotics it won't make a difference but might contribute towards antibiotics resistance on a global scale". GPs do not have microscope in their eyes they can't definitively say viral Vs bacterial without swaps.

If you don't have a benefit from an antibiotic there are two scenarios 1. It's viral the antibiotics will never have made a difference go and rest. 2. That antibiotic is not affective against the bacterial infection. Resolving both requires a thread swab to check for bacteria and then to find the most appropriate antibiotic. My gran had recurrent utis had to periodic get her urine tested to find the most effective antibiotic for her current strain. In combination with her dementia meant she would end up very poorly in hospital on a drip if they didn't get the antibiotics right. If they got it right it could be managed at home.

This is something I have been worrying about. Couldn't get an appointment today. They told me to call 111 if no improvement over the weekend. I will ask for swabs and a blood test for Epstein Barr virus.