Tonsillitis is most often caused by a virus, which resolves on its own. However, tonsillitis can be caused by strep throat bacteria, which requires treatment with antibiotics. Watch for signs of dehydration, such as a dry mouth and tongue. Also, watch for signs of complications, such as ear pain, from tonsillitis caused by strep bacteria.

Tonsillitis caused by a virus

Tonsillitis caused by a virus will usually go away on its own. Antibiotics are not effective treatment for viral tonsillitis.

The virus that causes mononucleosis (mono) can lead to tonsillitis that is as severe as tonsillitis caused by bacteria, and can take several weeks or more before it goes away.

Home treatments such as gargling with salt water, drinking warm tea, and taking nonprescription pain medicine for children age 6 months and older may help relieve discomfort. Nonprescription pain relievers, such as acetaminophen (Tylenol) or ibuprofen (Advil), should be given to children instead of aspirin. No one age 20 years or younger should take aspirin because of its link to Reye's syndrome. Acetaminophen should not be given to infants younger than 6 months without first consulting your health professional.

Many nonprescription remedies such as antiseptic mouthwashes, decongestants, and antihistamines contain extra ingredients that don't relieve discomfort. These remedies are not recommended for children because they have not been proved to have any benefits in the treatment of acute tonsillitis.⁴

Tonsillitis caused by bacteria

Antibiotics are prescribed for tonsillitis caused by strep bacteria. Although a strep infection will usually go away on its own, antibiotic treatment is necessary because untreated strep throat can cause serious complications. For more information, see the topic Strep Throat.

If antibiotics are prescribed, it is very important to take them exactly as directed by your health professional. Antibiotics should be taken for the entire duration of the prescription, even if the symptoms disappear completely before the prescription is gone. If antibiotics used to treat tonsillitis are not taken as directed, bacteria can become resistant to them (antibiotic resistance). In these cases, antibiotic treatment of future infections may not work.

Surgery

Although surgical removal of the tonsils (tonsillectomy) is still a common procedure, particularly for children, it is not performed nearly as often as it was in the past. Tonsillectomy may be considered to treat tonsillitis when a child has serious complications, recurrent infections, or chronic infections that do not respond to treatment and interfere with daily functioning. However, the risks and benefits of surgery need to be weighed carefully. Tonsillectomy should only be performed after you and your doctor carefully consider your or your child's overall health.¹ For more information, see:

Should my child have a tonsillectomy?

New tonsillectomy techniques are currently being evaluated but are not yet widely used. Ultrasonic dissection, cold ablation, laser tonsillectomy, and diathermy tonsillectomy are all techniques that may be offered as tonsillectomy options in the future.⁵