Inflammation of the throat causing pain, especially when swallowing. Most are viral and resolve without antibiotics. Bacterial tonsillitis requires antibiotic treatment.
Assess whether this is likely viral or bacterial. Viral sore throat: gradual onset, accompanied by runny nose, cough, and mild fever. Bacterial (streptococcal) tonsillitis: sudden severe throat pain, high fever above 38.5°C, white or yellow patches on the tonsils, swollen neck glands, no cough.
Gargle with warm salt water — half a teaspoon of salt dissolved in a glass of warm water. Gargle for 30 seconds and spit. Repeat every 2 to 3 hours. This reduces inflammation and kills surface bacteria.
Drink warm fluids consistently — warm water, herbal tea, warm broth. Cold drinks can temporarily numb the pain.
Take paracetamol or ibuprofen for pain and fever. Ibuprofen is more effective for throat inflammation.
Rest the voice. Avoid speaking loudly or whispering — whispering actually strains the vocal cords more than normal speaking.
Eat soft foods that are easy to swallow — porridge, soup, mashed foods, yoghurt.
Avoid smoking and smoke exposure — it significantly worsens throat irritation.
For viral sore throat: symptoms should improve within 5 to 7 days without antibiotics.
For suspected bacterial tonsillitis: see a doctor or pharmacist for antibiotic assessment.
Difficulty breathing or stridor — swollen throat obstructing airway.
Inability to open the mouth — possible peritonsillar abscess.
Drooling because swallowing is impossible.
Muffled or hot-potato voice with severe unilateral throat pain — peritonsillar abscess.
Stiff neck with sore throat and fever — rule out meningitis.
Sore throat lasting more than 2 weeks without improvement.
Do not take antibiotics without confirmation of bacterial infection — overuse causes resistance.
Do not give aspirin to children under 16.
A sore throat that makes breathing difficult is an emergency — go to hospital immediately.
Recurrent tonsillitis more than 5 times per year should be discussed with a doctor — tonsil removal may be considered.
✓ What Helps
· Ibuprofen 400mg with food — most effective for throat inflammation
· Paracetamol 1000mg as alternative
· Benzydamine throat spray or gargle — topical anti-inflammatory
· Throat lozenges with local anaesthetic for temporary relief
· Difflam spray for significant throat pain
✗ What To Avoid
· Antibiotics for viral sore throat
· Aspirin in children under 16
→ Ask The Pharmacist For
· Throat swab test if bacterial tonsillitis suspected
· Phenoxymethylpenicillin or amoxicillin for confirmed bacterial tonsillitis
· Clarithromycin if penicillin allergic
🏥 Get Professional Help
See a doctor immediately if you cannot breathe normally, cannot open your mouth, are drooling because you cannot swallow, or have a muffled voice with severe one-sided throat pain. These suggest a peritonsillar abscess which requires urgent drainage.