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How to treat recurrent tonsillitis?

Ear, Nose & Throat

I've had 3 episodes of tonsillitis with high fever in 2.5 months. There was also white pus at my tonsils. Each time, I was given antibiotics. I am concerned with the risks of over-relying on antibiotics. What are my treatment options for recurrent tonsillitis, and what are the key considerations for each of these treatment options?

DOCTOR’S ANSWER (2)

Hi,

Suffering from such severe tonsillitis in a short period of time must be really tough on you!

Your options are pretty clear actually: Either continue to have each attach treated with antibiotics or consider having surgery to remove your tonsils as the source of infection.

The drawbacks of having repeat courses of antibiotics are 1) antibiotic resistance to whatever bug causing the infections, 2) side effects of antibiotics such as tummy upset and diarrhea (loose frequent stools) and 3) that in more than half of tonsil infections, the cause may be viral rather than bacterial, so antibiotics may not really help at all!

In theory, I suppose if you’re willing to wait long enough, (for a totally unknown length of time) then some tonsillitis episodes will eventually settle down. But of course you won’t know for how long, it could take months or even years.

Surgical removal of your tonsils will get rid of the tonsils as the source of the recurrent infections and should make your sore throat episodes better. In theory, Long after you have your tonsils out, you can still potentially suffer a sore throat but this won’t be due to tonsillitis and instead an irritation of some other part of the throat.

There is an approximately 1-2% risk of postop bleeding after having your tonsils surgically removed, which may occur in the first 2 weeks after surgery. You will also suffer a bad sore throat for the first week or so as the tonsillectomy site heals. Most people tend to recover well though, and are quite Glad they had their surgery done rather than continue to suffer away with so many episodes of tonsil infections which keep them away from their work or studies!

Hope the above is helpful for you.

0 78 views 8 Jan 2019
Contact Doctor

Thank you for your question. I agree with Dr Annabelle that if you have been getting frequent tonsil infections (that were confirmed by your doctor) and requiring oral antibiotics for each episode, surgical removal of the tonsils (tonsillectomy) is certainly an option.

This is one of the most common surgical procedure performed by an ENT Specialist.

As Dr Annabelle has provided a comprehensive and good answer to your question, I shall not be repetitious but do have the following points to add:

  1. The tonsils are two ovoid-like glands that sit at the back of your throat. There is a right and a left tonsil and they are part of your immune organs. However, they play a very small role. Your body's immunity is largely derived from larger immune organs such as your liver, spleen, bone marrow and lymphatic system. Numerous studies have shown that tonsillectomy does not affect your immune system. Hence, you should not be worried about your immune system being "weaker" after a tonsillectomy. 
  2. As the history of your tonsil infection is only 2.5 months, observation is certainly an option provided that you do not mind enduring another infection and a course of oral antibiotics. We do not quite understand why some people are more prone to having frequent tonsil infections than others. If the cause of a tonsil infection is due to a virus, practising good hand hygiene (e.g. frequent hand washing) and staying away from people who has a viral infection may help prevent frequent attacks.

Hope this helps and all the best!

0 65 views 8 Jan 2019
Contact Doctor
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