Pharyngitis & Tonsilitis

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CLINICAL DESCRIPTION

Most sore throats are due to viral infections such as adenovirus and CMV and should not be treated with antibiotics. For pain or fever give analgesic treatment as required, be sure to rule out streptococcal pharyngitis to prevent acute rheumatic fever and other nonsuppurative (endocarditis) and suppurative complications (retropharyngeal and peritonsillar abscesses).

CLINICAL FEATURESSIGNS AND SYMPTOMS 

  • Abrupt onset of pain
  • Fever
  • Tender
  • Enlarged cervical lymph nodes
  • White or greyish pharyngeal exudates
  • Absence of lower respiratory tract signs and symptoms
  • Absence of signs suggesting viral nasopharyngitis (e.g. Rhinorrhoea, Conjunctivitis, Cough)

TREATMENT PHARMACOLOGICAL

Adults:

  • Give Benzathine Penicillin 1.2 MU single dose IM
  • Alternatively (if assured of compliance)
    • Give Amoxycillin 500mg 8 hourly for 7 days
  • Alternatively in penicillin hypersensitive patients:
    • Give Erythromycin 500mg 6 hourly for 7 days

Children:

  • Give Benzathine Penicillin 6MU if <30kg or 1.2 MU >30kg single dose
  • Alternatively (if assured of compliance)
    • Give Amoxycillin 15mg/kg 8 hourly for 7 days
  • Alternatively in penicillin hypersensitive patients:
    • Give Erythromycin 10mg/kg 6 hourly OR
    • Azithromycin 10mg/kg daily for 5 days

Note: 

  • Do not use cotrimoxazole as it is not effective
  • If there is pain or fever give analgesic treatment as required