Treatment of tonsillitis aims to relieve its symptoms. Surgery is very rarely required.
It is not always necessary to identify the exact cause of tonsillitis before beginning treatment, but it generally is advisable to at least determine whether the infection is due to streptococcal bacteria, so that appropriate treatment can be started. A "rapid strep" test is now available. If the test is positive, it is almost certain that your child's tonsillitis is caused by streptococcus bacteria. If the test is negative, a traditional laboratory culture will be needed.
Tonsillitis caused by streptococcus bacteria must be treated with penicillin or other suitable antibiotics in order to prevent the development of rheumatic fever. Penicillin is the best drug to use, unless your child has an allergy to it. It should be given by mouth for at least 10 days. Taking penicillin for shorter time periods may not completely clear up the infection.
Alternatively, a single intramuscular injection of long-acting penicillin can be given, but this is relatively painful. For children who are allergic to penicillin, other suitable antibiotics are available.
Tonsillitis due to viruses, like other infections due to viruses, does not respond to any currently known antibiotics.
Acetaminophen or ibuprofen may relieve sore throat and other symptoms of tonsillitis. Aspirin is best avoided in children of any age because of the risk of Reye's syndrome.
Tonsillitis may sometimes be due to other types of bacteria that also may respond to antibiotic treatment. Judgments about such treatment should be left to your doctor.