Despite the fact that tonsillitis is a widespread disease, its diagnosis and treatment remain a challenge for doctors. The cause is a bacterial infection caused by beta-hemolytic streptococcus suppurative A (BHSSA), which is present as the causative agent in 90% of cases. The peak incidence of streptococcal sore throat occurs in children aged 5-15 years. Incubation time is 2-6 days (for Streptococcus pyogenes infection). In children in the first 3 years of life, BHSSA is a rare cause of acute tonsillitis, whereas in adults it is responsible for 10% of cases. In other cases, other microorganisms and viruses play a role in the development of the disease. Incorrect identification of the causative agent of the disease is the main reason why sore throat does not go away after antibiotic therapy. The second factor is bacterial resistance.

Viral sore throat does not require the use of antibiotics. Treatment is based on bed rest and adequate fluid intake. For sore throat, locally acting remedies are recommended. The duration of the disease without complications is up to 7 days. A treatment option is to take antiviral drugs. If symptoms persist longer (do not go away for up to two weeks), we may be talking about a bacterial infection. In this case, in addition to a clinical examination, it is necessary to study the sedimentation of red blood cells and urine for the presence of protein. If the results do not indicate elimination of the disease, blood tests, ASLO (anti-streptolysin O antibodies) and (if necessary) microbiological tests are performed. A control swab from the throat is carried out in patients with prolonged symptoms of sore throat, relapses of the disease, in the case of a history of rheumatic fever, or a high risk of relapse (done within 1-2 weeks and, if necessary, after a month).

Resistance

The next factor responsible for the fact that a sore throat does not go away after antibiotics is the resistance (resistance) of the pathogen to the medicine used. Bacteriological persistence of streptococci after treatment of acute streptococcal tonsillitis (in particular, Penicillin) is demonstrated in 25% of patients, about half of them suffer from persistence of clinical signs of the disease. Detection of asymptomatic β-hemolytic streptococci usually does not require further therapy. Continued treatment is advisable in people with recurrent episodes of infections caused by this pathogen, complications of sore throat (rheumatic fever), or infection of other family members.

Read also: Decompensated chronic tonsillitis

Recurrent tonsillitis

The therapeutic problem may be recurrent (repeated) tonsillitis. The choice of the optimal treatment procedure is individual. If a sore throat does not go away after basic treatment, it is necessary to look for possible allergies, permanent transmission of infection, and a decrease in the body’s immunity. It is advisable to solve the problem in collaboration of different specialists.

The number of relapses is reduced by repeated therapy, i.e. treatment with antibiotics for 2-3 days after the symptoms of the disease have resolved, when prolonged antigenic stimulation of the macroorganism and the generation of antibodies that protect against further infections of the same type or serotype are possible.

In case of relapses in angina, the use of antibiotics that are active against microorganisms that produce β-lactamase helps. For recurrent streptococcal infections, the use of penicillin is not advisable - it will not be effective due to the high resistance of the bacterium; The following antibiotics are recommended that are active against β-lactamase-producing organisms:

• oral cephalosporins of the second generation;
• protected aminopenicillins;
• new generations of macrolides and Clindamycin.

Important! All of these groups of drugs act by a mechanism different from penicillins and cephalosporins, and are well concentrated in the tissues of the tonsils.

Immunomodulatory therapy, adenotomy (a procedure more common in children), and targeted re-treatment with antibiotics in the event of recurrent pathogenesis may be helpful.

The next alternative treatment for recurrent episodes of hemolytic streptococcal infections (other than tonsillectomy) is long-term use of low-dose penicillin (prophylaxis). But this approach is not often used in our country. If almond infections are not eliminated, the pain and redness of the throat after a sore throat does not subside, tonsillectomy is recommended.

Important! While tonsillectomies were performed on a one-size-fits-all basis in the 1950s, today the approach to treating sore throat, and therefore tonsillectomy, has changed, especially in children.

When deciding whether tonsillectomy is appropriate, many factors are taken into account: the severity of the infection, age, etc. Tonsilotomy, partial removal of the tonsils, is not recommended for recurrent inflammation or prolonged persistence of tonsillitis symptoms; it is intended only for cases of free-flowing tonsil hyperplasia that causes difficulty swallowing and breathing.

Read also: Sore throat in a nursing mother: should I stop breastfeeding?

Complications

Despite the prolonged persistence of sore throat symptoms, taking antibiotics somewhat reduces the inflammatory complications of the disease. Otolaryngologists are more likely to encounter local complications. They are caused by the spread of infection into the tonsil capsules and include parathyroid cellulitis and abscesses. If left untreated for prolonged or recurrent sore throat, there is a risk of more severe complications requiring specialized treatment. Such complications are caused by the invasion of infection into the deep cervical spaces with thrombophlebitis of the jugular vein, mediastinum and sepsis. General complications are the manifestation of a post-streptococcal immune reaction with a wide range of manifestations and consequences. They are divided into inflammatory and non-inflammatory.

Treatment Basics

While most patients with acute tonsillitis are treated empirically based on clinical trials, further research to accurately identify the pathogen and its possible drug resistance is important when dealing with tonsillitis that does not resolve with primary therapy. The goal of treatment is to suppress the infection, suppress ongoing clinical symptoms, and prevent potential complications.

Local treatment is aimed at a disease not caused by streptococcus. Antimicrobial drugs, local antiseptics, disinfectants, and local antibiotics are used, to which the microorganism is not resistant.

Systemic treatment includes antimicrobial drugs, vitamins, and antipyretics.

The first line treatment is Penicillin, used for 7-10 days. During this period, it is important to conduct microbiological examinations. If there is no improvement in the general and local condition after the start of treatment (up to 3-4 days) or a microbiological study has confirmed the resistance of the microbial agent to Penicillin, the antibiotic should be replaced.

The main challenge in determining appropriate treatment is meeting requirements based on the causative agent. Inflammatory changes in the mucous membranes most often have an infectious origin, where the main causes are viral, bacterial or fungal infections. These changes are often secondary, caused by previous mechanical, thermal or chemical damage to the tissue. Sometimes inflammation is associated with secondary lesions due to tumor changes. In addition, the persistence of symptoms after treatment of angina may be associated with diseases of proximal or distant organs, systemic diseases, and manifestations of intolerance to medications taken. An aggravating factor is the virulence of pathogen strains, the degree of cytotoxicity, the immune status of the sick person, and the presence of anatomical abnormalities in the respiratory tract.

Treatment for sore throat sometimes does not give a positive result; several factors can influence this. Symptoms persist for 2 weeks or more, why does this happen?

Causes of prolonged sore throat:

1. Antibiotics chosen incorrectly. The pathogen turned out to be immune to them.
2. The patient violated the course of taking antibiotics.
3. The doctor made a mistake with his diagnosis.
4. The patient did not listen to the words of the attending physician.

If at least one of the points applies to you, then you need to take action. There is no need to wait, improvement will not come from inaction.

To recover, you first need to go to the hospital. The doctor will prescribe a course of antibiotics that will neutralize the causative agent of the infection and prevent complications from appearing. Such drugs can be in different dosage forms: solution, tablets, powder, capsules. They must be taken according to a physician's prescription. Self-prescribing treatment is prohibited.

In addition to medications, you need:

1. Watch your diet, it should be balanced. Eat more vegetables and fruits. Drink more fluids to flush out toxins from your body. Give preference to still water, herbal and green teas, compotes, fruit drinks, and natural juices. Everything is drunk warm.
2. Gargle with decoctions of medicinal herbs and other special solutions to cleanse the tonsils of pus, plaque and mucus, relieve inflammation and disinfect.
3. Make warming alcohol compresses.
4. Do not get too cold and do not irritate the throat mucosa with cold liquid or food.
5. Walk more in the fresh air and ventilate the room.
6. During treatment, do not drink alcohol and stop smoking, as the smoke will irritate the sore throat.

Keep in mind that if you do not feel better after treatment and following all recommendations for two weeks or more, then you should think about changing your doctor or even clinic.

There are often situations when a patient repeatedly visits a doctor with a problem - a sore throat does not go away, despite the treatment received. What to do in such cases, what may be the cause of a protracted illness and what treatment methods to choose?

It is important to understand that there is no cause for concern if the elevated temperature persists for 4–5 days after the start of therapy, but the patient’s condition has improved dramatically. This means that hyperthermia is triggered by a large amount of toxins in the cells. But if the patient’s well-being not only does not change for the better, but also worsens, this is a reason for an urgent consultation with a doctor and solving the problem.

If a sore throat does not go away for a long time, you should initially think about making an incorrect diagnosis. Acute tonsillitis, unlike chronic tonsillitis, is much more severe - the patient experiences high fever, weakness, loss of appetite, the follicular spaces are filled with pus, but 3-4 days after the start of treatment, the symptoms should subside, and after 10 days they should go away completely.

When, despite regular use of antibiotics, after two weeks or a month the disease makes itself felt again, this is the first sign of chronic tonsillitis. Additional confirmation is the fact that more than once a year a person does not get a sore throat, which means that the pathology has become chronic.

The doctor could mistakenly mistake yellow plugs in the lacunae of the tonsils for festering follicles. Also, initially the patient could have hidden the medical history data from the doctor, or the ENT specialist simply did not want to understand this issue.

A sore throat does not go away, what to do - the patient asks when he comes to see a doctor a week after successful treatment. Usually, after recovery, the body acquires strong immunity, so that even contact with the mucous membrane of the tonsils will not cause a recurrence of the disease. In rare cases, with constant contact with a patient with chronic tonsillitis, or with severe autoimmune diseases, re-infection occurs.

What to do in such a situation? Treat again, but with the use of immunomodulators and antifungal drugs, since long-term antibiotic therapy can cause candidiasis of the throat mucosa.

There are several more reasons why a sore throat does not go away; they lie in the incorrect implementation of medical procedures prescribed by the doctor:

• Incorrect gargling. Everyone knows that the rinsing procedure is the most important point in the treatment of sore throat, while pathogenic bacteria are washed off from the surface of the mucous membrane, purulent plugs are softened, mucus is washed out and inflammation is reduced. But if the rinsing is done too intensely, the patient gets the opposite effect by massaging the tonsils. During tonsillitis, the lacunae are filled with purulent contents; strong pressure on them does not remove the exudate, but causes it to be driven even deeper inside, so the sore throat drags on, complicated by inflammation of the lymph nodes. Read more about gargling →
• Drink. Drinking plenty of warm water helps remove toxins, soften the mucous membrane and normalize water balance during tonsillitis. If the patient drinks hot tea or juices from the refrigerator, he achieves additional irritation of the throat, the same can be said about eating sour, salty and spicy foods.
• Compresses. To relieve a sore throat, both warm and cool compresses are used for sore throat. Cold will relieve discomfort, and heat will improve blood circulation in the tissues. If the technique of carrying out procedures is violated, the sore throat will drag on for a long time, for example, after a hot compress or visiting a bathhouse, you cannot immediately go out into the cold air or douse yourself with water, as healthy people can do. Read more about how to make a compress →

Usually, if all of the listed conditions for the treatment of angina are met, recovery occurs in 10-14 days, and there should be no relapse of the pathology for at least a year.

If a sore throat does not go away after antibiotics, there may be several reasons for this. The first is that the causative agent of the disease is resistant to the drug, and no positive changes in the patient’s condition are observed during treatment. Most often, resistance of microorganisms is observed to drugs of the penicillin group (Penicillin, Ampicillin, Amoxicillin), cephalosporins (Cefalexin, Cefadroxil), and less often to macrolides (Azithromycin, Sumamed, Josamycin).

There have been no recorded cases of no reaction to Augmentin, Sultamicillin and Amoxiclav, therefore, if treatment with these medications does not produce results, most likely the diagnosis was incorrectly made, or the patient violated the rules for taking medications.

Why pathogens may not respond to antibiotics:

• the initial resistance of the bacterium that caused the disease;
• improper use of antibiotics, such as gargling or putting them into the nose;
• a doctor prescribing medications that have already been used to treat a patient’s sore throat, but they did not give positive results.

The second reason why sore throat does not go away for a long time after antibiotics is their unjustified use. Many patients believe that a fever and sore throat are the first signs of bacterial tonsillitis, although it can be caused by a virus or fungus. Antibiotics will not only not help here, but will even worsen the situation, therefore, if a sore throat does not go away for a month, you should not engage in self-diagnosis and treatment.

The following signs will help distinguish viral and fungal sore throat from bacterial:

• runny nose - it is a companion to ARVI, but not to sore throat, although in rare cases there are exceptions;
• white spots not only on the tonsils, but on the base of the tongue and the arches of the soft palate are a sign of a fungal infection of the throat (with sore throat, purulent plugs form only on the surface of the tonsils and in the lacunae).

And the third reason why a sore throat does not go away after antibiotics is considered to be a violation of the rules of prescribed therapy. For example, when a patient voluntarily discontinues the drug after the symptoms of the disease disappear (after 5–6 days, instead of the prescribed course of 10–14).

The patient can also replace the drug for internal use with antibacterial lozenges, believing that the effect will be the same, but when such drugs are absorbed, there is no effect on the infectious agent.

Another case of violation of the rules is the irregular use of medications, when the patient takes tablets twice a day instead of three, or instead of the drug in injections, he himself replaces it with an analogue for internal use. For example, bicillins must be administered intramuscularly, and if Azithromycin is taken orally with food, this will greatly impair absorption.

Why a sore throat may not go away for a long time is now clear; all that remains is to find out what to do for a complete cure. There are several options:

1. Go to the doctor again to identify the type of pathogen and determine the sensitivity of the bacteria to the prescribed drug.
2. After changing the medication, strictly follow the instructions for use, do not replace the drug with others and do not violate the rules of use.
3. Do not start self-treatment, relying only on your own knowledge about sore throat - symptoms may indicate pharyngitis, chronic tonsillitis, viral or fungal infection, and it is pointless to treat them with antibiotics.
4. Increase immunity to avoid repeated cases of infection.
5. Remember that the key to successful treatment is an integrated approach - regular and proper gargling (4-5 times a day), drinking warm drinks (water, green tea, fresh berry fruit drinks, milk with soda) and applying compresses.

A mandatory visit to a doctor for persistent sore throat is the main condition for successful and safe treatment. Prolonged self-therapy can lead to loss of tonsils, severe heart defects and chronic kidney pathologies.

If the patient strictly follows the instructions, does not violate the rules for taking medications, does not self-medicate, and the symptoms of the disease appear again and again, and the doctor insists on tonsillitis and does not want to conduct a detailed examination, it is worth changing the doctor. After all, long-term use of antibiotics with an unspecified diagnosis causes candidiasis of the mucous membranes, dysbiosis and other complications, and the true cause of regular throat problems remains unclear.

Sore throat is considered to be an infectious disease, because it is caused by various viruses and bacteria. On average, the duration of the disease is from five to ten days, depending on the form of its manifestation. But what to do when a sore throat does not go away?

Sore throat is an independent disease. And it is characterized by several symptoms.

• Severe pain in the throat. At the same time, they intensify during conversation and swallowing food.
• Redness of the tonsils and nearby tissues.
• The appearance of pustules and plaque.
• A sharp rise in temperature to forty degrees.
• Deterioration of general condition.
• The occurrence of weakness and body aches.
• Enlarged lymph nodes and their pain.

When a sore throat occurs, inflammation of the lymph nodes is inevitable. When germs enter the oral cavity, they immediately settle on the tonsils. But further development of the process depends on immune function. If it is weakened, then the inflammatory process begins to spread to the nearest lymph nodes. They are located directly next to the pharynx under the lower jaw.

Lymph nodes with angina are greatly enlarged in size, and when they are palpated, severe pain is felt.

With a sore throat, first one lymph node begins to become inflamed, and then the infection spreads to the other side. To reduce inflammation of the lymph nodes, it is necessary to eliminate the infection. Therefore, treatment includes several important recommendations.

1. Determination of the form of sore throat. There are several types of it: bacterial, viral and fungal. If tonsillitis is bacterial in nature, then the patient must take broad-spectrum antibiotics. The duration of treatment is from five to ten days. For viral sore throat, it is recommended to use antiviral agents. They need to be taken for up to seven days. If the sore throat has a fungal form, then antifungal medications will help cure the disease. Whatever form of tonsillitis occurs, you need to see a doctor. Self-medication can become life-threatening for the patient.
2. Elimination of symptoms. To relieve pain in the throat, swelling of the tonsils and lymph nodes, it is necessary to carry out local therapy. It includes:
   Gargling six to ten times a day. For the procedure, solutions of furatsilin, soda and salt, and herbal decoctions are used.
   the use of absorbable tablets that have antiseptic properties. These include Faringosept, Lizobakt, Grammidin.
   Irrigation of the throat with antiseptic agents in the form of Miramistin, Hexoral, Tantum Verde.

   If the patient experiences an increase in temperature, chills, fever and headaches, then painkillers and antipyretics should be taken. These include Paracetamol, Aspirin, Ibuprofen, Ibuklin.

3. Compliance with the regime. To avoid adverse consequences and recover quickly, you must adhere to a special regime. It includes:
   bed rest for five days;
   drinking large amounts of liquid;
   balanced diet rich in vitamins;
   eating soft foods that do not irritate the throat.

Warming up the lymph nodes during a sore throat and touching them is strictly prohibited during the acute period of the disease. This method of treatment will be not only ineffective, but also dangerous. When warming up, blood circulation improves, as a result of which the infection can enter the blood and spread throughout the body.

Many patients complain about why a sore throat does not go away. This process can be influenced by several reasons. They include.

• Pathogen immunity to antibiotics. This situation is often observed when taking drugs that belong to the penicillin group. The patient may feel worsening.
• Incorrect diagnosis. Very often, a sore throat is mistaken for chronic tonsillitis. The disease can also be confused in form. If antibiotic treatment was carried out for fungal or viral sore throat, then they will be useless.
• Violation of antibiotic use. Many patients, when improvements occur, stop taking the antibiotic on the second or third day. This process leads to bacterial resistance and greater proliferation. Then, against the background of this, the patient develops a recurrent sore throat. Complications may occur.
• Failure to follow doctor's recommendations. The treatment process includes not only taking antibiotics, but also local treatment of the throat. If the patient neglects the recommendations, the improvements will not be noticeable.

It is worth noting that if treatment is ineffective, then the patient:

• the temperature will not subside;
• painful sensations in the throat will not disappear;
• the lymph nodes will be greatly enlarged;
• the condition will noticeably worsen.

If a sore throat does not go away after antibiotics and an increase in symptoms is observed, then you need to visit a doctor and be examined again.
Patients often confuse chronic tonsillitis with tonsillitis. If repeated relapses occur after a sore throat, this indicates a chronic course of the disease. In terms of symptoms, these two diseases are similar, but chronic tonsillitis is much milder, and the symptoms are not so pronounced. It is worth noting that in the chronic form, the throat is not so red, and the lymph nodes do not increase in size much.

When treated with antibiotics, rapid recovery occurs, but chronic tonsillitis requires additional treatment.

• Strengthening immune function with vitamin complexes or immunostimulants.
• Washing the lacunae of the tonsils. In this case, the procedure is recommended to be carried out even after recovery in order to avoid relapses.
• Elimination of those causes that cause exacerbation of the disease.

The question then arises, why does an error occur during diagnosis? There are three main reasons.

1. Similarity of symptoms of chronic and acute course of the disease.
2. Insufficient information from the patient about accompanying symptoms.
3. The doctor's reluctance to understand the problem more globally.

What then should the patient do in such a situation? If the diagnosis was made incorrectly, then the whole problem is the doctor’s insufficient qualifications. Sore throat can be confused not only with chronic tonsillitis, but also the form of the disease itself can be incorrectly identified. At

fungal sore throat

a whitish milky coating with an unpleasant odor is observed. Viral sore throat is similar to a cold, and plaque and blisters on the tonsils do not always appear.

Bacterial sore throat

characterized by a yellowish coating and the formation of pustules. In such a situation, the patient should consult another doctor.

It also happens that a person diagnoses himself and prescribes antibiotics. And he does it in vain. Self-treatment leads to complications. Against the background of a sore throat, not only chronic tonsillitis can appear, but also heart and kidney defects.

If the patient stops taking antibiotics on the third day, then there is no point in taking them again. Then you need to visit a specialist again and take an oral swab to test for the pathogen and its resistance to antibiotics. After the examination, the doctor will prescribe another drug. The main recommendation is to take the medicine for at least seven days. Antibiotics must be used according to instructions.

Also, the duration of a sore throat depends on compliance with the regimen. Patients believe that once the temperature returns to normal, they can go to work or go outside. But doing this is strictly prohibited. Any improvement may be replaced by a worsening of the condition. The same can be said about drinking liquid. It should be drunk not only during high temperatures, but also throughout the entire recovery period. At a temperature, water helps prevent dehydration, and during rehabilitation, remove all harmful substances and microbes from the body.

Once the patient has recovered, several important rules must be followed to avoid relapses.

1. Compliance with hygiene measures. It is necessary to constantly wash your hands and face with soap. If a person often suffers from a sore throat, then it is worth purchasing a special antibacterial agent.
2. Avoid contact with infected people. Sore throat has two main modes of transmission:
   airborne droplets during talking, coughing and sneezing;
   contact and household through toys, dishes, clothes and even touch.
3. Strengthening immune function. Regardless of the patient’s age, hardening procedures must be carried out. This may include a contrast shower, walking barefoot on wet rugs, and wiping. In the summer, doctors recommend walking barefoot on grass, sand and stones.
   Also, medications containing vitamins and minerals influence the strengthening of function. They need to be taken in courses, taking a break in the summer.
4. Maintaining a healthy lifestyle. Adults should give up such a bad habit as smoking. You also need to engage in active recreation and sports.
5. Balanced diet. It is worth giving up fast foods and semi-finished products. This food is considered harmful. Preference should be given to cereals, vegetables, fruits, dairy and fermented milk products, as well as fish and meat.
6. Daily walks outside.

There is no need to treat a sore throat on your own. The treatment process must take place under the strict supervision of a doctor.

Sore throat after antibiotics occurs again (or does not go away at all) in several cases:

1. The causative agent of the disease is resistant to the antibiotic. This is a normal situation when taking drugs of the penicillin group, more rare for cephalosporins and macrolides. In this case, the sore throat does not go away after antibiotics at all, and the patient does not feel relief;
2. The diagnosis was made incorrectly and an exacerbation of chronic tonsillitis was mistaken for a sore throat. Sometimes patients even call tonsillitis itself with plugs in the tonsils a sore throat;
3. Again, an error in diagnosing the disease and an attempt to treat fungal or viral tonsillitis or pharyngitis with antibiotics. Antibiotics do not act on fungi or viruses, and such a “sore throat” will not go away with their use;
4. Violation of the rules for the use of antibiotics. For example, if the patient stopped taking them on the third day of treatment, when he felt better, a re-exacerbation of the disease or the development of chronic tonsillitis is likely. In this case, repeated sore throat after antibiotics may develop after several weeks or months, in extremely rare cases - after several days;
5. Re-infection soon after treatment. A very rare, almost exceptional case.

It is important to understand that if, with a sore throat, the temperature simply does not subside after antibiotics, but the patient’s general condition returns to normal, this is not a cause for concern. The temperature in many cases remains high not so much because of the activity of the pathogen, but because of the presence in the tissues and blood of a large number of bacterial cell residues and toxins. It is normal if the temperature remains elevated for a week when using effective antibiotics, but it should drop to subfebrile values ​​(37-38°C), and the patient’s general condition should normalize. If antibiotics do not help with a sore throat, the patient will not get better.

A patient with tonsillitis has a normal body temperature 1-2 days after starting antibiotics.

In general, if all the rules of antibiotic therapy for angina are followed, situations should not arise when antibiotics do not help. These cases occur due to the fact that the doctor prescribes the drug without identifying the pathogen and its resistance to various drugs, or due to errors in diagnosis, or when the rules for taking the drug are violated.

Staphylococcus is a bacterium that is very often resistant to many antibiotics, including penicillins.

How to determine the specific reason why a sore throat does not go away after antibiotics or occurs again, and what to do in a particular case?

In this case, both situations are possible:

1. The disease does not go away after antibiotic therapy;
2. The disease passes, but soon a re-exacerbation of tonsillitis develops. The primary or previous exacerbation ends, since this is normal for sore throat (it cannot be chronic), and the next one develops against the background of weakened immunity, accidental re-infection and other reasons.

But in general, the insensitivity of the angina pathogen to the antibiotic is manifested precisely by the absence of any effect from taking the drug.

Staphylococcus surrounded by metabolic products. Among them are enzymes that break down and deactivate penicillins.

Reasons for pathogen resistance to antibiotics:

1. The initial resistance of the strain of bacteria that infected the patient;
2. Violation of the rules of antibiotic therapy: local use of systemic drugs (for example, instilling antibiotics into the nose for a runny nose, gargling with them);
3. The use of medications with which this patient’s sore throat has already been treated before and the treatment did not produce results.

The last case, by the way, is a flagrant violation of the rules of antibiotic therapy, which doctors sometimes allow. There are known situations when a doctor, in the old fashioned way, prescribes penicillin injections to a patient with a sore throat, not paying attention to the fact that the same patient’s disease has already been treated several times with such injections, which in a particular case do not help.

How is it determined?

First of all, by the absence of changes in the patient’s condition, sometimes by its deterioration. In medical practice, it is generally accepted that if noticeable changes do not occur within 48 hours after the start of use, the antibiotic should be replaced, or the diagnosis should be rechecked.

Benzylpenicillin sodium salt is an outdated antibiotic, which is ineffective in every fourth case.

What should the patient do?

Visit a doctor. If he doesn’t change the antibiotic, doesn’t take a throat swab for analysis to determine the sensitivity of bacteria to drugs, but simply says that you need to wait - go to another doctor. After changing the drug and adjusting the treatment, the patient must strictly adhere to the doctor’s instructions for taking the drug.

This situation is characterized by repeated exacerbations of the disease after antibiotic therapy. Symptomatically and clinically, they resemble sore throats, but a specialist can distinguish them by individual signs. Exacerbations of chronic tonsillitis are usually milder and faster than sore throats, and therefore, regardless of antibacterial therapy, the patient quickly feels relief.

Also, sometimes patients consider chronic tonsillitis itself to be a sore throat. In this case, it is also likely that antibiotics do not affect the course of the disease or the appearance of the tonsils.

Typical appearance of tonsils in chronic tonsillitis. The stones are clearly visible.

It is important to understand that chronic tonsillitis can also be treated with antibiotics. But in addition, it is important to wash the lacunae of the tonsils, strengthen the immune system, and eliminate factors that contribute to the exacerbation of the disease.

Washing tonsil lacunae in the clinic

Causes of diagnostic errors:

1. The similarity of the manifestations of exacerbation of tonsillitis and tonsillitis;
2. The patient’s refusal to tell the doctor his medical history, or the doctor’s reluctance to deal with this issue.

How is it determined?

As a rule, if repeated sore throat after antibiotic therapy occurs constantly and at short intervals - a week, two weeks, a month - we are talking about chronic tonsillitis. Normally, this disease does not occur more often than once a year. In addition, if a patient constantly has yellow plugs on his tonsils (which are often confused with festering follicles in follicular tonsillitis), and the tonsils themselves are always enlarged, this also indicates a chronic disease.

Plugs in the tonsils that turn into hard formations.

What should the patient do?

If the treatment of chronic tonsillitis with an antibiotic was prescribed by a doctor who confused the disease with a sore throat, you should find another doctor. Otherwise, there is a risk of treating the disease for several years, and in the end you will still have to undergo surgery and lose your tonsils. Such cases do occur.

If the patient himself diagnosed himself with a “sore throat” and decided to take antibiotics for it, stop playing doctor and turn to a good specialist. Otherwise, you can not only lose your tonsils, but also develop severe heart defects and chronic kidney disease.

This is one of the most common reasons why antibiotics do not help with sore throat. Many patients at home diagnose themselves with the disease and believe that if their throat hurts and their temperature rises, it is a sore throat and it needs to be treated with antibiotics. Moreover, in many cases, viral tonsillitis and pharyngitis, which are not affected by antibiotics, manifest themselves as similar symptoms.

Throat affected by Coxsackie virus

Also, many patients look into the throat, see white spots in the throat and decide that this is definitely a purulent sore throat, although we are talking about fungal pharyngitis. Antibiotics will not only not help with this, but may even worsen the situation.

How is it determined?

In many cases, only a doctor can distinguish viral and fungal diseases of the throat from a sore throat. Moreover, sometimes it is difficult even for a specialist to differentiate by external signs, for example, catarrhal tonsillitis from viral pharyngitis, or tonsillomycosis from lacunar tonsillitis. In general, the distinguishing features here are:

1. Runny nose - it does not develop with a sore throat; with a viral disease it is normal. But there are exceptions;
2. Spread of white spots beyond the tonsils - onto the palate, palatine arches, base of the tongue. In this case, we are talking specifically about a fungal infection of the pharynx, since with angina, pus is localized only on the tonsils.

In addition, if a sore throat does not go away after antibiotics such as Augmentin, Amoxiclav, Flemoklav Solutab, erythromycin or azithromycin (not to mention the expensive drugs of the latest generation - Vilprafen, Timentin), we are talking about a viral or fungal disease. These antibacterial drugs for sore throat almost always work.

A fungus of the genus Candida, which only flourishes when taking antibiotics.

What should the patient do?

Stop self-diagnosis and self-medication and consult a doctor. If the disease is viral, symptomatic treatment is prescribed; if it is fungal, antifungal agents are taken. If a doctor prescribed an antibiotic, after two days of unsuccessful use of antibiotics, he must clarify the diagnosis and prescribe the correct treatment. If this does not happen, you should see another doctor.

In many cases, gross violations of the rules of antibiotic therapy are also the cause of repeated exacerbations or the fact that a sore throat does not go away after antibiotics at all. For example:

• Stop taking antibiotics earlier than prescribed by your doctor. The minimum treatment period is 7 days, normal is 10-15. Azithromycin alone can be taken for 5 days, and sometimes for 3 days, but in the latter case the incidence of repeated exacerbations of the disease is high;
• Replacement of systemic antibiotics with local ones. Some patients believe that if they suck on lozenges or tablets with antibiotics during a sore throat, the result will be similar to taking these drugs systemically. In fact, when dissolving tablets or gargling with antibiotics, there is no effect on the infection, and the disease will definitely not go away with such treatment;
• Irregular use of antibiotics, or taking them in violation of instructions. For example, azithromycin, when taken simultaneously with food, is absorbed into the blood much worse and may not have an effect on the disease; bicillins should only be administered intramuscularly. Due to ignorance of these features, medications may not work as they should.

This situation is most typical for adult patients who are not properly treated, but buy an antibiotic as directed by a doctor and drink it when they accidentally remember it.

How is it determined?

Just from memory. If the patient does not remember the last time he took the drug, in what quantity, and what the doctor said about taking it, most likely there were violations of the rules of administration.

A container that reminds the owner of the time to take the pill.

What should the patient do?

Take the drug according to the instructions. If the situation does not improve, or the disease recurs, you need to go to the doctor for re-diagnosis (perhaps we are already talking about chronic tonsillitis) and adjustment of treatment.

This situation is almost hypothetical. After successful treatment of a sore throat, the body retains a fairly strong immunity, the number of immune system cells in the tonsils and antibodies in the blood remains high for a long time, and repeated exposure of the pathogen to the tonsils will not cause disease. In addition, the causative agent of sore throat itself needs to be picked up somewhere else. Exceptions are situations when the patient has an immunodeficiency, or constantly works with patients (for example, doctors, internship students).

Macrophages are cells of the immune system that specifically hunt and eat bacteria.

How is it determined?

This situation is quite typical: after taking antibiotics, the sore throat quickly ended, the patient recovered, and he had no signs of chronic tonsillitis. After some time, a typical sore throat developed. Again, this is what we are talking about here, and not about viral infections of the throat - they can develop after a successfully treated sore throat.

What should the patient do?

Treat sore throat again. Be sure to consult a doctor, since repeated use of antibiotics can provoke the development of a fungal disease. And in general, this situation is non-standard and the doctor must make sure that the recurrent illness is a sore throat.

Any problems in the treatment of sore throat should be addressed to a specialist.

• Repeated sore throat after antibiotics, or simply a lack of effect from the use of these drugs, is a consequence of violation of the rules of antibiotic therapy;
• Only a doctor can determine why antibiotics do not help completely get rid of the disease;
• If a sore throat does not go away after antibiotics, this is a signal that everything possible must be done to cure the disease. In this case, the patient must see a doctor. Otherwise, the disease may become chronic or complications may develop.

Hello, dear visitors of our site! Many people suffer from chronic tonsillitis, which, until a certain time, practically does not make itself felt. But then an exacerbation begins, which can last for several months. At the same time, there is no fever, but the throat hurts for a long time and painfully. Many people don’t even try to identify the cause and think that everything will go away on its own. But after a month it can only get worse, and you have to contact an ENT doctor, who ultimately makes a diagnosis of “chronic tonsillitis”. And then a long treatment begins, and patients learn where the tonsils are and how to take care of them. Our site was created to shed light on the question: what kind of disease is “tonsillitis”, how to prevent it and how to treat it?

What is tonsillitis?

An unpleasant disease with a beautiful name - “tonsillitis” - is familiar to many. Often, once a person has had it, they cannot get rid of it for years. What kind of illness is this, what are its causes and can it be cured?

Tonsillitis is an inflammation of the tonsils (tonsils). There are acute and chronic tonsillitis. Acute tonsillitis, or in common parlance, sore throat, is a disease familiar to everyone from childhood, in which a high temperature rises and the throat hurts very badly. Also among the symptoms of acute tonsillitis you can find enlarged tonsils of a bright red color, which can be ulcerated, covered with pustules and film. As a child, I had a sore throat several times, which probably caused tonsillitis to become chronic.

Chronic tonsillitis occurs in a milder form, and often practically does not make itself felt, with the exception of several times a year, and in my case much longer. Symptoms during exacerbation of chronic tonsillitis are less pronounced; the throat may be slightly sore and sore, and there is usually no fever. In my case, the symptoms were an intensifying sore throat at times, and very severe dryness and scratchiness, especially when breathing in the cold winter air.

Forms of chronic tonsillitis

Doctors talk about chronic tonsillitis in cases where the tonsils are constantly in an inflamed state, and there can be 2 options: the first - tonsillitis seems to completely disappear, but with any hypothermia its symptoms immediately return; second - the inflammation practically does not go away, it only subsides, while the patient feels satisfactory, but the doctor sees that the tonsillitis has not disappeared anywhere, but has entered a subacute stage. In both cases, it is necessary to take measures to achieve long-term (preferably several years) remission.

In medical language, these are compensated and decompensated forms of chronic tonsillitis. If you have only local symptoms of chronic tonsillitis - slight inflammation of the tonsils, sore throat, and there are no manifestations in the general condition of the body, then in this case you have a compensated form of tonsillitis, i.e. The tonsils compensate and level out the state of inflammation, and more or less cope with their functions.

If you have frequent inflammation of the tonsils, and this is accompanied not only by a sore throat, but also by various acute sore throats, paratonsillitis (inflammation around the tonsils), and diseases of other organs that seem to be unrelated to this, then this is a decompensated form of tonsillitis.

In my case, tonsillitis occurs in a compensated form, which is amenable to conservative treatment and prevention. And now I understand that the tonsils are a very important organ of the immune system, and this disease cannot be neglected. I also learned that, unfortunately, it is impossible to cure chronic tonsillitis forever, but it is quite possible to live with it if you constantly carry out prevention.

Causes of chronic tonsillitis

ENT doctors often joke that 100% of the population suffers from chronic tonsillitis. In a sense, this is true: a huge number of bacteria constantly “live” on the tonsils, it’s just that healthy tonsils easily cope with pathogens, but sick ones do not have enough strength to do this. There are several reasons for the disease to enter the chronic stage. Most often, doctors talk about the following:

1. The main cause of chronic tonsillitis is called untreated tonsillitis. Remember: as soon as the terrible sore throat and fever subside, you stop taking antibiotics (and this should under no circumstances be done) and happily run to work, thinking that the illness has passed. Yes, it has receded, but most likely not for long: after a sore throat, you need to gargle for a few more days, take vitamins (and without fail a full course of antibiotics, otherwise all treatment is down the drain), and be sure to strengthen your immune system, otherwise chronic tonsillitis will become your companion for a long time.

2. The second reason is frequent pharyngitis, which usually neither doctors nor patients pay due attention to. Well, my throat hurt for a few days and it went away. You don’t even have to take sick leave: pharyngitis often goes away with virtually no treatment in 3-5 days. But the pathological process, if not stopped in time, will definitely go further - it only takes the slightest weakening of the immune system or overwork of a person for bacteria to begin to multiply uncontrollably, capturing more and more new territories.

Any acute pharyngitis must be treated to the end! After all, it is much easier to deal with it than to treat chronic tonsillitis, and it can cause fewer unpleasant consequences.

3. It is necessary to carefully monitor dental hygiene and periodontal condition. If you are tormented by tonsillitis, consult a dentist and have your teeth treated, try to prevent gum disease. The fact is that an infection that has settled in the oral cavity has every chance of “making its way” further, right up to the tonsils.

4. Oddly enough, the causes of chronic tonsillitis can be hidden in a completely unexpected place: for example, you may be tormented by chronic rhinitis or even an aggravated allergic runny nose from time to time - and now doctors are starting to talk about the development of chronic tonsillitis.

Goodbye tonsillitis!

One of the main causes of chronic tonsillitis is reduced immunity. It is very difficult to cope with chronic tonsillitis without strengthening the immune system. Therefore, first of all, it is necessary to support your body so that it has the strength to fight the disease. Homeopathy and hardening have proven themselves to be excellent here. In addition, you can contact an immunologist, he will help you figure out why the body is losing strength and prescribe the necessary medications. You may need to take a course of tonsil rinsing.

You can’t just “give up” on chronic tonsillitis! It tends to be long-lasting and persistent, and the infection can spread further - complications may arise in the heart, kidneys and other vital organs. In this case, they speak of a decompensated form of tonsillitis, which requires removal of the tonsils (tonsillectomy). And it is better not to allow this, because they are the gates that close the way to many diseases.

Do not despair! We'll fix everything. If some types of treatment do not help, others will. You just need to tune in to a long fight and believe in victory over the disease - then it will definitely recede!

Treatment of chronic tonsillitis: what methods to use?

Treatment of chronic tonsillitis in a simple compensated form is sufficient to carry out locally: gargle with various solutions and herbs (furacilin, sage, chamomile, etc.), use various sprays (for example, tantum verde). Also, the ENT doctor prescribed me a drug called “tonsilgon”, it is alcohol-based, it’s quite disgusting to drink, but they say that it is quite effective, and, after all, it probably contributed to the treatment of my tonsillitis.

Washing tonsil lacunae for chronic tonsillitis

Also, in the treatment of chronic tonsillitis, rinsing the lacunae of the tonsils is prescribed. This procedure includes rinsing the throat, washing out infected purulent plugs from the tonsils (in case of severe exacerbation). Hospital conditions ensure that the procedure is carried out - a powerful stream of antibacterial or disinfectant solution is directed from a large syringe under pressure into the lacunae. Immunostimulating or antifungal liquids can be used.

As a rule, a furatsilin solution is used to wash the tonsils, and miramistin, chlorhexidine, streptococcal and staphylococcal bacteriophages are also used.

Many clinics have special equipment with which the contents of the lacunae can not only be washed, but also suctioned out. For example, you can rinse the tonsils using the Tonsilor device. Using this procedure, you can reduce the number of relapses, improve the condition and reduce the size of the tonsils, and also relieve inflammation from the tissues.

Physiotherapeutic methods

Physiotherapeutic treatment of chronic tonsillitis can be effective during remissions - laser therapy is recognized as very effective due to its antibacterial and anti-inflammatory effect due to its direct effect on the tonsils. Short-wave UV radiation of the throat and oral cavity is also used.

There are methods of ultrasonic treatment of the tonsils, which act on the source of the disease itself, destroying the structure of the resulting cheesy mass. Using ultrasound, you can also irrigate the tonsils with antiseptic solutions.

An effective remedy is inhalation of wet steam. But there is one contraindication here - high temperature, so the temperature must first be lowered, and only then inhalation. Inhalations can be used using various medicinal herbs - chamomile, calendula, etc., chlorhexidine solution, or you can simply breathe over potatoes. You should not take deep breaths when inhaling, because in the case of tonsillitis, only the inflamed tonsils need to be affected.

To relieve swelling of the pharynx, you can use antihistamine therapy - this is a very long process, but it leads to a reduction in the tonsils. In this case, you can take drugs such as Suprastin, Tavegil, Loratadine.

Complex treatment is usually used, and such therapy is carried out at least twice a year.

Removal of tonsils

Surgical treatment of chronic tonsillitis (tonsillectomy) is carried out in cases where exacerbations of the disease occur very often - 2-4 or more times a year (with a decompensated form of chronic tonsillitis), in cases of inflammation spreading to tissues close to the tonsils (paratonsillitis), in the event of a general infection blood (sepsis), as well as when there are signs of damage to other organs (heart, kidneys).

In the case of surgical treatment, the tonsils are completely removed, or their size is reduced due to partial cutting off of overgrown tissue (tonsillectomy is often performed in childhood). In this case, the number of exacerbations of chronic processes can be significantly reduced.

However, there is no need to rush into this, since serious complications may arise after complete removal of the tonsils, so it is better to try all conservative treatment methods first. At the same time, the type of specific pathogen is identified, and based on the information received, treatment is prescribed, which is accompanied by the use of immunostimulating and restorative drugs, as well as active physiotherapy, and all this is carried out in an intensive form and, if necessary, is repeated.

In any case, no one advises self-medication, since it’s more expensive to joke with tonsillitis, therefore, if symptoms persist for a long time, you should definitely contact an ENT doctor who will examine your sore throat and, based on this, prescribe the appropriate one for your case treatment.

In case of severe inflammation and enlargement of the tonsils, injection therapy can be prescribed - antibiotics are injected directly into the tissue of the tonsils, suppressing the activity of pathogenic bacteria.

To increase the local immunity of the tissue, it is worth rinsing the tonsils with antiseptic solutions, as well as lubricating them with different compounds; in addition, this will reduce swelling and reduce the number of exacerbations.

Prevention of chronic tonsillitis

For effective treatment of chronic tonsillitis, it is necessary to constantly stimulate the body with appropriate drugs. To prevent exacerbations of tonsillitis, we can recommend hardening, taking immune-strengthening drugs (Immunal, Imudon), as well as moderate physical activity and maintaining a healthy lifestyle.

Also, if you suspect even the slightest signs of exacerbation of tonsillitis, do not start, immediately start gargling. Many sick people have tried the effectiveness of furatsilin solution: it is enough to gargle 3-5 times a day, and in a few days you can prevent the development of the disease.

So, in general, we briefly talked about a disease such as tonsillitis. Of course, there is a lot more that can be told, but it will not fit on one page, so we have divided the entire site into thematic sections to make it more convenient for you to read all the material presented.

Attention! All articles on the site are purely informational. We recommend that you seek qualified help from a specialist and make an appointment.

Chronic tonsillitis is a condition of the palatine tonsils, in which, against the background of a decrease in local natural protective functions, periodic inflammation occurs. Therefore, the tonsils (tonsils) become a constant source of infection, with chronic allergization and intoxication of the body. Symptoms of chronic tonsillitis clearly manifest themselves during periods of relapse, when during an exacerbation the body temperature rises, the lymph nodes become enlarged, pain appears, a sore throat, pain when swallowing, and bad breath.

Against the background of reduced immunity and in the presence of a chronic focus of infection, patients with chronic tonsillitis may subsequently suffer from diseases such as rheumatism, pyelonephritis, adnexitis (see inflammation of the uterine appendages - symptoms and treatment), prostatitis, etc. Chronic tonsillitis, sinusitis, sinusitis - these are social diseases of a modern resident of a metropolis, since the unfavorable environmental situation in cities, monotonous chemical diets, stress, overwork, and an abundance of aggressive, negative information have a very negative impact on the state of the population’s immune system.

Why does chronic tonsillitis occur?

The main function of the palatine tonsils, like other lymphoid tissues in the human pharynx, is to protect the body from pathogenic microorganisms that enter the nasopharynx with food, air, and water. These tissues produce protective substances such as interferon, lymphocytes, and gammaglobulin. In the normal state of the immune system, both non-pathogenic and conditionally pathogenic microflora are always present on the mucous membrane and deep in the tonsils, in the lacunae and crypts, in the correct, natural concentrations, without causing inflammatory processes.

As soon as there is an intensive growth of bacteria coming from outside or opportunistic bacteria present, the palatine tonsils destroy and remove the infection, leading to normalization of the condition - and all this happens unnoticed by the person. When the balance of microflora is disturbed for various reasons described below, a sharp growth of bacteria can cause tonsillitis - an acute inflammation that can occur in the form of lacunar tonsillitis or follicular tonsillitis.

If such inflammations become protracted, often recur and are difficult to treat, the process of resistance to infection in the tonsils weakens, they fail to cope with their protective functions, lose the ability to self-cleanse and themselves act as a source of infection, then a chronic form develops - tonsillitis. In rare cases, in about 3%, tonsillitis can develop without a preliminary acute process, that is, its occurrence is not preceded by a sore throat.

In the tonsils of patients with chronic tonsillitis, bacterial analysis reveals almost 30 pathogenic bacteria, but in the lacunae the most numerous are streptococci and staphylococci.

Before starting therapy, it is very important to take a test for the bacterial flora to establish sensitivity to antibiotics, since there is a wide variety of pathogenic microorganisms and each of them can be resistant to certain antibacterial agents. If antibiotics are prescribed at random, if the bacteria are resistant, the treatment will be ineffective or not at all effective, which will lead to an increase in the recovery period and the transition of sore throat to chronic tonsillitis.

Diseases that provoke the development of chronic tonsillitis:

Impaired nasal breathing with - polyps (nasal polyps, treatment), adenoids (treatment of adenoids in children), purulent sinusitis, sinusitis (sinusitis treatment with antibiotics), deviated nasal septum, as well as dental caries - can provoke inflammation of the tonsils Decreased local and general immunity in infectious diseases - measles (see symptoms of measles in adults), scarlet fever, tuberculosis, etc., especially with severe cases, inadequate treatment, incorrectly selected drugs for therapy. Hereditary predisposition - if there is a family history of chronic tonsillitis in close relatives.

Unfavorable factors that provoke exacerbation of chronic tonsillitis:

A small amount of fluid consumed per day. A person must drink at least 2 liters of liquid per day, as well as poor quality of water consumed daily (use only purified water for cooking, special water filters) Severe or prolonged hypothermia of the body Severe stressful situations, constant psycho-emotional stress, lack of adequate sleep and rest, depression, chronic fatigue syndrome Work in hazardous industries, dust, gas pollution in the workplace General unfavorable environmental conditions in the place of residence - industrial enterprises, abundance of vehicles, chemical production, increased radioactive background, abundance of low-quality household goods in the living area emitting harmful substances into the air - cheap household appliances, carpets and furniture made from toxic materials, active use of household chemicals (chlorine-containing products, washing powders and dishwashing detergents with a high concentration of surfactants, etc.) Alcohol abuse and smoking Poor diet , an abundance of carbohydrates and proteins, limited consumption of cereals, vegetables, fruits.

When the process begins to take on a chronic form in the tonsils, the lymphoid tissue from tender gradually becomes denser, being replaced by connective tissue, scars appear covering the lacunae. This leads to the appearance of lacunar plugs - closed purulent foci in which food particles, tobacco tar, pus, microbes, both living and dead, and dead epithelial cells of the mucous lacunae accumulate.

In closed lacunae, figuratively speaking, pockets where pus accumulates, very favorable conditions are created for the preservation and reproduction of pathogenic microorganisms, the toxic waste products of which are carried throughout the body through the bloodstream, affecting almost all internal organs, leading to chronic intoxication of the body. This process occurs slowly, the overall functioning of the immune mechanisms is disrupted and the body may begin to react inadequately to a constant infection, causing allergies. And the bacteria themselves (streptococcus) cause serious complications.

Symptoms and complications of tonsillitis

Chronic tonsillitis, according to the nature and severity of inflammation, is divided into several types:

A simple recurrent form, when sore throats often occur A simple protracted form is a long-term, sluggish inflammation in the tonsils A simple compensated form, that is, relapses of tonsillitis and episodes of tonsillitis occur quite rarely Toxic-allergic form, which comes in 2 types

In the simple form of chronic tonsillitis, the symptoms are scant, limited only to local signs - pus in the lacunae, purulent plugs, swelling of the edges of the arches, enlarged lymph nodes, a sensation of a foreign body, discomfort when swallowing, dry mouth, bad breath. During periods of remission, there are no symptoms, but during exacerbations, sore throats occur up to 3 times a year, which are accompanied by fever, headache, general malaise, weakness, and a long recovery period.

1 toxic-allergic form - in addition to local inflammatory reactions, general signs of intoxication and allergization of the body are added to the symptoms of tonsillitis - increased body temperature, heart pain with normal ECG readings, joint pain, increased fatigue. The patient suffers more severely from influenza and ARVI, and recovery from illness is delayed.

2 toxic-allergic form - with this form of the disease, the tonsils become a constant source of infection, and there is a high risk of it spreading throughout the body. Therefore, in addition to the above symptoms, disorders occur in the joints, liver, kidneys, functional disorders of the heart, detected by ECG, heart rhythm is disturbed, acquired heart defects may occur, rheumatism, arthritis, and genitourinary diseases develop. A person constantly experiences weakness, increased fatigue, and low-grade fever.

Conservative local treatment of chronic tonsillitis

Treatment of chronic tonsillitis can be surgical or conservative. Naturally, surgical intervention is an extreme measure that can cause irreparable harm to the immune system and protective functions of the body. Surgical removal of tonsils is possible when, due to prolonged inflammation, lymphoid tissue is replaced by connective tissue. And in cases where a peritonsillar abscess occurs in toxic-allergic form 2, its opening is indicated.

Indications for tonsil removal:

Enlarged tonsils interfere with normal nasal breathing or swallowing. More than 4 sore throats per year Peritonsillar abscess Conservative therapy without effect for more than a year There was an episode of acute rheumatic fever or there is chronic rheumatic disease, renal complications

The palatine tonsils play an important role in creating an infection barrier and restraining the inflammatory process, and are one of the components of supporting both local and general immunity. Therefore, otolaryngologists try to preserve them without resorting to surgery; they try to restore the functions of the palatine tonsils using various methods and procedures.

Conservative treatment of exacerbation of a chronic process should be carried out in an ENT center, with a qualified specialist who will prescribe comprehensive adequate therapy depending on the form and stage of the disease. Modern methods of treating tonsillitis are carried out in several stages:

Washing lacunae

There are 2 ways to rinse the lacunae of the tonsils - one using a syringe, the other using the nozzle of the Tonsilor apparatus. The first method is considered obsolete today because it is not effective enough, the pressure created by the syringe is insufficient for thorough rinsing, and the procedure is traumatic and contact-based, often causing a gag reflex in patients. The greatest effect is achieved if the doctor uses the Tonsilor attachment. It is used both for rinsing and for administering medicinal solutions. First, the doctor rinses the lacunae with an antiseptic solution, while he clearly sees what is being washed out of the tonsils.

Ultrasonic medicinal irrigation, Lugol treatment

After cleaning the pathological secretion, you should change the tip to an ultrasonic one, which, due to the ultrasonic effect of cavitation, creates a medicinal suspension and with force delivers the medicinal solution into the submucosal layer of the tonsils. The medicine usually used is a 0.01% solution of Miramistin; this product is an antiseptic that does not lose its properties under the influence of ultrasound. Then, after this procedure, the doctor may treat the tonsils with Lugol's solution (see Lugol for sore throat).

Therapeutic laser

A laser therapy session also has a good effect, reducing swelling and inflammation of the tissues and mucous membrane of the tonsils. To achieve better results, the laser radiation source is placed in the oral cavity closer to the tonsils and the back wall of the pharynx.

Sessions of vibroacoustic influence, Ural Federal District

Such sessions are performed to normalize microcirculation and improve nutrition in the tissues of the tonsils. UFO - ultraviolet irradiation is carried out to sanitize the microflora; this is an old time-tested method that has not lost its relevance and is considered quite effective.

All described methods must be carried out in courses, the number and frequency of which are determined individually in each specific clinical case. To achieve maximum effect, 5 to 10 rinsing procedures are required until clean rinsing water appears. This course of treatment is able to restore the ability of the tonsils to cleanse themselves and the period of remission is significantly extended, relapses become less frequent.

To avoid removal of the palatine tonsils and the treatment leads to a lasting result, it is advisable to carry out such effective treatment 2-4 times a year and carry out maintenance preventive treatment yourself at home, gargle (see all solutions for gargling for sore throat).

Recent research by scientists leads to the conclusion that in chronic sinusitis, sinusitis, and tonsillitis, an imbalance in the microflora of the nasopharyngeal mucosa plays an important role and opportunistic microorganisms begin to multiply when there is an insufficient amount of beneficial flora that inhibits the growth of pathogenic bacteria. (see Causes of sinusitis include dysbiosis of the sinuses)

One of the options for preventive and supportive treatment of tonsillitis may be gargling with preparations containing live cultures of acidophilic lactic acid bacteria - Narine (liquid concentrate 150 rubles), Trilact (1000 rubles), Normoflorin (160-200 rubles). This normalizes the balance of the microflora of the nasopharynx, promotes more natural healing and longer remission.

Effective drug treatment

Only after establishing an accurate diagnosis, clinical picture, degree and form of chronic tonsillitis, the doctor determines the patient’s management tactics, prescribes a course of drug therapy and local procedures. Drug therapy consists of the use of the following types of drugs:

Antibiotics for tonsillitis

The doctor prescribes this group of drugs only during exacerbation of chronic tonsillitis; it is advisable to treat with antibiotics based on bacterial culture data. Prescribing drugs blindly may not lead to the desired effect, loss of time and worsening of the condition. Depending on the severity of the inflammatory process, the doctor may prescribe antibiotics for a sore throat, either a short course of the easiest and safest drugs, or a longer course of stronger drugs that require the use of probiotics (see also Sumamed for sore throat). In case of latent tonsillitis, treatment with antimicrobial drugs is not indicated, since this additionally disrupts the microflora of the gastrointestinal tract and oral cavity, and also suppresses the immune system (see 11 rules on how to take antibiotics correctly).

Probiotics

When prescribing aggressive broad-spectrum antibiotics, as well as for concomitant diseases of the gastrointestinal tract (gastritis, colitis, reflux, etc.), it is necessary to take probiotic drugs resistant to antibiotics at the same time as starting therapy - Acipol, Rela Life, Narine, Primadophilus, Gastrofarm, Normoflorin (see the entire list of probiotics - dietary supplements and Linex analogues)

Painkillers

For severe pain, the most optimal is Ibuprofen or Nurofen; they are used as symptomatic therapy and for minor pain their use is not advisable (see the full list and prices of non-steroidal anti-inflammatory drugs in the article Injections for back pain).

Antihistamines

To reduce swelling of the mucous membrane, swelling of the tonsils, and the back wall of the pharynx, it is necessary to take desensitizing drugs, as well as for more effective absorption of other drugs. Among this group, it is better to use the latest generation of drugs; they have a longer, prolonged effect, do not have a sedative effect, are stronger and safer. Among the antihistamines, the best can be identified - Cetrin, Parlazin, Zyrtec, Letizen, Zodak, as well as Telfast, Fexadin, Fexofast (see List of all allergy medications). If one of these drugs helps a patient well during long-term use, there is no need to change it to another.

Antiseptic local treatment

An important condition for effective treatment is gargling; for this you can use various solutions, either ready-made sprays or dilute special solutions yourself. It is most convenient to use Miramistin (250 rubles), which is sold with a 0.01% solution spray, Octenisept (230-370 rubles), which is diluted with water 1/5, as well as Dioxidin (1% solution 200 rubles 10 ampoules), 1 amp. diluted in 100 ml of warm water (see list of all throat sprays). Aromatherapy can also have a positive effect if you gargle or inhale with essential oils - lavender, tea tree, eucalyptus, cedar.

Immunostimulating therapy

Among the drugs that can be used to stimulate local immunity in the oral cavity, perhaps only Imudon is indicated for use, the course of therapy is 10 days (absorbable tablets 4 times a day). Among the products of natural origin, you can use Propolis, Pantocrine, ginseng, and chamomile to boost immunity.

Homeopathic treatment and folk remedies

An experienced homeopath can select the optimal homeopathic treatment and, if his recommendations are followed, remission can be prolonged as much as possible after the acute inflammatory process has been relieved using traditional methods of therapy. And for gargling, you can use the following medicinal plants: string, sage, chamomile, eucalyptus leaves, willow buds, Icelandic moss, aspen bark, poplar, as well as the roots of burnet, elecampane, and ginger.

Emollients

Due to the inflammatory process and the use of certain medications, dry mouth, soreness, and soreness in the throat appear; in this case, it is very effective and safe to use apricot, peach, and sea buckthorn oils, taking into account the individual tolerance of these drugs (absence of allergic reactions). To thoroughly soften the nasopharynx, you should instill any of these oils into your nose, a few drops in the morning and evening; when instilling, you should throw your head back. Another way to soften the throat is 3% hydrogen peroxide, that is, 9% and 6% solution should be diluted and gargle with it for as long as possible, then gargle with warm water.

Diet therapy is an integral part of successful treatment; any tough, hard, spicy, fried, sour, salty, smoked food, very cold or hot food, saturated with flavor enhancers and artificial additives, alcohol - significantly worsens the patient’s condition.

Sore throat is an infectious disease accompanied by acute inflammation of the tonsils and/or other lymphoid formations of the pharynx. For many people, all it takes to get a sore throat is to eat ice cream or get your feet wet. Development is also promoted by other diseases of the nasopharynx and irritating substances that enter the pharynx (alcohol, dust, tobacco smoke, and so on). The following pathogenic microorganisms can provoke the development of pathology: viruses, bacteria and fungi.

In the article, we will look in more detail at the causes and first signs of tonsillitis, talk about symptoms in adults, and also tell you which treatment is most effective.

What is a sore throat?

Sore throat is a common disease, second in frequency to acute respiratory viral infections and influenza. Most often the palatine tonsils become inflamed. This is a seasonal disease, usually manifesting itself in the autumn and spring periods.

About 75% affect people under 30 years of age, of which the largest percentage belongs to children under 15 years of age (about 60%).

Sore throat is very contagious, so isolation of the patient is mandatory.

A sore throat is caused by various microbes, mainly streptococci, which often enter the throat with household items used by a person with a sore throat (for example, dirty dishes, etc.).

In some cases, microbes that are in the throat and usually do not cause disease are activated under the influence of certain unfavorable conditions, for example, during cooling or sudden fluctuations in ambient temperature.

Types and forms

Depending on the clinical course, frequency of the disease and the cause of angina, they are divided into different groups.

In adults, there are 3 types of sore throat:

• Primary tonsillitis. Primary angina is understood as an acute infectious disease of predominantly streptococcal etiology, with relatively short-term fever, general intoxication, inflammatory changes in the lymphoid tissues of the pharynx, most often in the palatine tonsils and the lymph nodes closest to them. The duration of the incubation period ranges from 12 hours to 3 days. Characterized by an acute onset with hyperthermia, chills, pain when swallowing, and enlarged regional lymph nodes.
• Secondary or symptomatic. Damage to the tonsils in the pharynx is observed against the background of such pathologies: diphtheria, agranulocytosis, leukemia, etc.
• Specific sore throat. Caused by a specific infectious agent (fungi, spirochete, etc.).

Classification of sore throats in adults:

• Catarrhal sore throat. Usually develops very quickly and acutely. In most cases, a person falls ill suddenly, with malaise, dryness and a sore throat. Duration from 3 to 7 days.
• Follicular tonsillitis. The most characteristic sign of this form of angina is the accumulation of fibrinous exudate in the lacunae. At the same time, whitish plaques form on the swollen and hyperemic mucous surface of the tonsils, localized at the mouths of the lacunae. More often they are separate formations, less often they merge together and cover most of the surface of these organs. The duration of the disease is 6 – 8 days.
• Lacunar tonsillitis. The tonsils are affected in the area of ​​the lacunae, with subsequent spread of purulent plaque to the surface of the palatine tonsils. When performing pharyngoscopy, infiltration and swelling of the tonsils, severe hyperemia and widening of the lacunae are observed. This type of sore throat lasts 6–8 days.
• Necrotizing tonsillitis. On the surface of the tonsils, large areas of dead tissue are visible, going deep and covered with a lumpy coating of gray or yellow-green color. Foci of necrosis become saturated with fibrin and become denser. After their removal, bleeding occurs, and then an ulcer up to 2 cm in size, with uneven edges, forms.
• Phlegmonous - this type of sore throat most often occurs against the background of supposedly passing classic signs of sore throat - the tonsils begin to swell again, the soft palate turns red.
• Herpangina. Most often develops in children. Called A and is a highly contagious disease. The virus carrier is a sick person; in rare cases, they can be pets.
• Ulcerative-membranous is a sore throat without fever. The patient usually experiences necrosis of one of the tonsils with the formation of an ulcer. The patient complains that he feels a foreign body when swallowing, his salivation increases, and there is a putrid odor from his mouth.

Causes

The primary focus of inflammation is formed in the lymphoid tissue of the oropharynx. Causes predisposing to the disease may be local and general hypothermia, dusty and polluted atmosphere, increased dryness of rooms, decreased immunity, etc.

In most cases, sore throat develops, which reduce the protective functions of the epithelium in the respiratory tract, thereby opening the path to infection.

From person to person, sore throat is transmitted by airborne droplets or nutritional (food) routes. With endogenous infection, microbes enter the tonsils from carious teeth, paranasal sinuses () or the nasal cavity. When the immune system is weakened, sore throat can be caused by bacteria and viruses that are constantly present on the mucous membranes of the mouth and pharynx.

Ways of infection entering an adult body:

• Airborne (the most typical route of transmission).
• Enteral (together with contaminated dairy products).
• Hematogenous (with blood flow from organs and tissues infected with the pathogen).
• Endogenous (in patients suffering from gastroenteritis, purulent sinusitis, and caries).
• Artificial (during surgical operations on the nasopharynx and nasal cavity (traumatic tonsillitis)).

In addition, the following reasons can provoke the disease in adults:

• improper and irrational nutrition;
• severe fatigue of the body;
• living in unfavorable conditions;
• lack of sufficient sunlight;
• constant dampness.

Considering that sore throat in the vast majority of cases is caused by streptococci, and rheumatism and glomerulonephritis arise precisely from streptococcal infections, treatment in adults begins with penicillin antibiotics.

Symptoms of sore throat + photos

The incubation period (the time spanning the period of introduction of a pathogenic factor into the human body until the first clinical symptoms) lasts on average about 10-48 hours.

Common symptoms of sore throat in adults:

• Temperature increase. Specific reaction of the human body to the pathogenic activity of bacterial agents. High temperature promotes the rapid removal of toxins from the body, enhances the immune response, and also reduces the rate of bacterial growth;
• chills and malaise;
• headache appears due to intoxication of the human body with waste products of pathogenic microorganisms;
• increased fatigue;
• pain in the joints (the symptom is typical for both children and adults).
• Difficulty swallowing. This symptom develops as a consequence of inflammation of the tonsils. This reduces the opening of the oropharynx, which makes it difficult for food to pass through it. Also, when swallowing, pain increases, which causes the patient to be careful when making swallowing movements.
• If the disease is severe, then areas of necrosis that have a dark gray color form on the tonsils. Dead tissue is rejected, being replaced by defective areas measuring 10 mm.

Adults become infected from a carrier of the infection who releases it into the external environment. A significant role here is played by a close team at work, the use of shared cutlery and dishes, and a careless attitude to the rules of personal hygiene.

In the photo below, you can see what a sore throat looks like in an adult:

The photo shows an accumulation of pus on the tonsils - this is a characteristic sign of tonsillitis

	Symptoms in adults
Catarrhal sore throat	The inflammatory process affects the mucous membrane of the tonsils, and provokes unexpressed pain during swallowing. Manifests: Low-grade fever (temperature rise to 37-38°C) Mild malaise Possible enlarged lymph nodes Enlargement and redness of the palatine tonsils themselves
	It is purulent tonsillitis, and its development is accompanied by the appearance of suppuration on the tonsils in the form of light yellow bubbles.
	The appearance of characteristic signs at any age: pain in the throat area, increased swelling of the palatine tonsils, rise in body temperature, the appearance of signs of intoxication in the body in the form of headaches, attacks of nausea and vomiting, an increase in the size of the lymph nodes in the submandibular region, the appearance of plaque (colored yellow-white) at the mouths of the lacunae.
Necrotic form	Accompanied by the following symptoms: persistent fever headache, vomiting, confusion.
Viral	The main symptom of a viral sore throat is severe pain in the front of the neck. In addition, the patient experiences symptoms such as: chills; feverish condition; sore throat; grayish coating on the tonsils; swelling of the neck; bad breath; voice change.

What to do when the first signs appear?

The first signs of a sore throat appear very quickly. In most cases, a bacterial form develops, in which the patient complains of a sore throat and plaque on the tonsils. Viral sore throat is often accompanied by lacrimation, runny nose, and others. Treatment depends on the type of pathogen (bacteria or virus).

The patient is isolated in another room and given separate dishes and care items. He must comply with the following rules:

1. bed rest in the first days of illness, especially at high temperatures;
2. limiting physical activity;
3. non-irritating, soft food, mainly vegetable and dairy, plenty of warm drinks.

Complications for the body

Despite the fact that sore throat seems to be a minor disease and many people ignore its comprehensive treatment, it is fraught with numerous complications. Complications of angina are conventionally divided into local and general.

Local complications of sore throat:

• abscesses of surrounding soft tissues (formation of large cavities filled with pus);
• phlegmon (diffused accumulation of pus, unlimited);
• otitis;
• swelling of the larynx;
• bleeding from the tonsils.

Are common:

• rheumatism;
• kidney damage;
• gastrointestinal tract damage;
• penetration of infectious agents from the throat into the chest;
• spread of infectious agents into the cranial cavity;
• – the most severe complication of tonsillitis.

To avoid these complications, it is necessary to consult a specialist in time to choose the right tactics for treating sore throat.

Diagnostics

When the first symptoms of the disease appear, you should contact an ENT doctor or an infectious disease specialist. If this is not possible, a general practitioner or pediatrician, as well as a family doctor, can make a diagnosis and prescribe treatment. If complications develop, a cardiologist, nephrologist, and rheumatologist participate in the treatment of the patient.

When making a diagnosis, the clinical picture of the disease, anamnesis data are taken into account, and the patient is prescribed pharyngoscopy and a bacterial culture test. It is mandatory to carry out a differential diagnosis of sore throat with ARVI, acute pharyngitis and pharynx.

The main signs to identify a bacterial infection:

• severe redness and swelling of the tonsils and uvula;
• with areas of gray plaque;
• coating on the tongue;
• enlarged cervical lymph nodes;
• the formation of a peritonsillar abscess, in which one tonsil is pushed towards the center of the soft palate, towards the uvula, is a sign of severe disease;
• pain accompanied by drooling, difficulty speaking, difficulty swallowing and breathing.

Treatment of sore throat in adults

In most cases, treatment of angina is carried out on an outpatient basis, but in case of severe cases, the patient is hospitalized in the infectious diseases department. Do not forget that you should limit the patient’s communication with family members so as not to spread the infection.

Provide the patient with separate dishes and a towel. With proper and timely treatment, recovery occurs in approximately seven days.

Medicines are prescribed to the patient depending on what symptoms he or she has. In case of severe pain, he needs to take anesthetic substances.

Drugs for the treatment of sore throat:

1. Fusafungin (bioparox) - inhalation, 4 inhalations by mouth every 4 hours for 4-5 days. May cause irritation of the nasopharyngeal mucosa, bronchospasm, and allergic reactions.
2. Ambazon - keep the tablet in your mouth until it is completely dissolved (adults 3-5 tablets per day, children from 3 to 7 years old 1 tablet 3 times a day for 3-4 days). After taking the tablet, refrain from eating and drinking for 3 hours.
3. Gramicidin - the tablet is kept in the mouth (behind the cheek) until it is completely dissolved. Use 2 tablets (one after the other for 20-30 minutes) 4 times a day for 2-3 days.
4. In severe cases of the disease, the use of the following drugs is recommended: Hexoral Stopangin Strepsils Luxury Lugol.
5. Antihistamines. The following drugs are indicated: Suprastin, Tavegil, Fenkarol, Claritin, etc.
6. To reduce body temperature and reduce pain, antipyretic drugs and analgesics are prescribed.
7. For sore throat, the symptoms subside thanks to absorbable tablets with menthol-based drugs. Instead, you can use special aerosols. Their use helps relieve pain that occurs in the throat during a sore throat.

In that case, if the body temperature lasts more than 5 days, the treatment regimen should be changed, as this indicates its ineffectiveness.

Antibiotics

In adults, antibiotics may not be used at the first sign of illness. They are indicated only in case of bacterial nature of the infection. With properly selected antibacterial therapy, the patient's condition improves quickly. But the doctor’s task is not only to quickly recover the patient, but also to prevent the development of complications. This is achieved by completely destroying the pathogen, which occurs when antibiotics are used for at least 10 days.

How many days, in what way, and what dosage of the medicine should be taken is prescribed by the attending physician.

Gargling

It is important to remember that when gargling, pathogenic microorganisms are washed out from the mucous membrane, so this must be done as often as possible. When gargling at home, you can use the following solutions:

• herbal decoctions
• furatsilina
• hydrogen peroxide.

After recovery, the patient is prescribed a control laboratory test, and if signs of complications are detected, consultation and subsequent treatment with a specialized specialist is strongly recommended.

Diet

This meal includes the following dishes:

• Porridges made with water or milk (oatmeal, rice, semolina) are liquid in consistency, reminiscent of jelly.
• Puree soups, broths (with pieces of bread).
• The bread should be white, without yeast and not too fresh, but not stale.
• Boiled and preferably pureed or pureed vegetables: potatoes, tomatoes, cabbage, pumpkin.
• Pasta, but small ones are better.
• Boiled eggs, omelettes.
• Dietary fish varieties: bream, pollock, cod.
• Steamed or boiled dishes: cutlets, meatballs. They are prepared from dietary meat: chicken, veal, rabbit.
• Dairy products should be low in fat. Cottage cheese is taken to a cream-like consistency.
• Fruits need to be baked or boiled.

When treating tonsillitis it is necessary:

• reduce the amount of proteins (up to seventy grams), carbohydrates (up to three hundred grams), fats (up to about sixty grams);
• increase the number of meals up to five times, eat in small portions;
• boil food, steam it, and then serve it in chopped form;
• eat vegetables, various cereals;
• do not eat hot or cold foods;
• drink drinks containing vitamins: fruit drinks, herbal teas, sugar-free jelly.

Folk remedies

Traditional methods of treatment are aimed at reducing inflammation in the pharynx, strengthening the body's defenses, and speeding recovery after illness. For these purposes, decoctions of plants with anti-inflammatory effects (chamomile, sage, oak bark), teas and infusions of berries with a high content of vitamins (currants, cranberries, rose hips) are used.

1. Calendula inflorescences, plantain leaves, wormwood herb- all equally. Pour 1 tablespoon of the mixture into 1 cup of boiling water, simmer over low heat for 10-15 minutes, strain. Gargle with warm solution every 2 hours.
2. Beetroot juice. Grate the beets, squeeze out the juice and gargle with it. Using the same analogy, you can prepare carrot juice, either used alone or diluted with beet juice.
3. Sage leaf - 3 parts, chamomile flowers - 3 parts, love spell herb - 3 parts, brew 1 teaspoon of the mixture with 1 glass of boiling water, leave for 30 minutes, strain. Gargle for sore throat and.
4. 3-5 pieces of spicy cloves pour a glass of boiling water and leave for 2 hours. Take 50 g of the infusion, but you can take the whole infusion depending on the severity of the disease.
5. Grate a glass of beets, pour in a tablespoon of vinegar, let the mixture settle. Then squeeze out the juice, gargle with it and swallow 1-2 tablespoons.

Forecast

As for the prognosis of treatment, for catarrhal tonsillitis the prognosis for treatment is favorable in all cases. The disease goes away especially quickly if treatment is started in a timely manner. Favorable prognosis for the treatment of follicular and lacunar tonsillitis. But still, they can lead to the development of chronic tonsillitis.

Severe complications are caused by necrotizing tonsillitis of any form of complexity. The most common complications are rheumatism and glomerulonephritis.

Prevention

Preventing a disease is always more profitable and easier than treating it. Prevention of sore throat is no exception. At home, you can carry out some simple procedures and follow rules that reduce the risk of getting sick:

• In order to avoid contracting a sore throat, it is also important not to maintain contact with a person with a sore throat, not to use common household items, etc.
• Daily exercises, walking in the fresh air, wiping and dousing with cold water, contrast showers - all this can work wonders on the immune system;
• Proper nutrition. It directly affects the immune system, therefore, it should be rich in healthy food that carries vitamins and minerals to the body, and not fat and cholesterol.
• And one of the basic rules for adults is sanitation of the oral cavity, timely treatment of diseases such as caries, nasal congestion, etc.

At the first symptoms of a sore throat, be sure to consult a therapist or ENT doctor for proper treatment.

This is all about angina: what are its main symptoms and signs, how to treat it in children and adults, can it be cured quickly and at home. Do not be ill!

Which is slightly inferior in frequency to the flu and colds. It is not for nothing that the word translated from Latin means “I squeeze, squeeze.” In the acute form of the pathology, the tonsils increase in size so much that they cover the entire throat, preventing breathing and swallowing. In this case, the patient experiences severe pain. Treatment of sore throat will be successful with the use of antibacterial agents. But it happens that even after antibiotics, a sore throat does not go away. There are several reasons for this.

There are several pathogenic microorganisms leading to. In first place are streptococcal bacteria. You can only fight them with antibiotics. But not all medications can completely destroy the pathogen. Bacteria are most resistant to antibiotics of the penicillin group: Ampicillin, Amoxicillin. But new generation antibacterial agents - macrolides and cephalosporins - have a strong effect, and pathogen resistance to them rarely occurs.

Microorganisms become resistant to antibiotics when the infection is not diagnosed in adults. And they:

• use medications that do not eliminate the symptoms of the disease;
• incorrect use of antibacterial medications;
• self-medicate, selecting medications at their own discretion.

The resistance of bacteria to a specific agent can be determined when there is no improvement after treatment within 2 days. In this case, the medication is replaced with a more effective drug.

The viral nature of inflammation of the tonsils cannot be cured with antibiotics. Other means are needed here. The presence of a viral infection is determined by a runny nose, which is a companion to ARVI. Signs of fungal infection of the tonsils include a whitish coating on neighboring tissues. In this case, only antimycotics will help, not antibacterial agents.

Initially incorrect diagnosis

Exacerbation of sore throat even after treatment occurs due to poor diagnosis. Only collecting anamnesis, relying on the patient’s complaints and external examination of the sore throat will not give a complete picture of the disease.

It is important for the doctor to determine the type of infectious agent and the form of the disease. Therefore, it is necessary to examine a smear taken from the surface of the inflamed tonsils.

If after recent therapy your throat hurts again, then this is most likely a chronic form of infection. In this case, the tonsils will be permanently enlarged. The patient feels a sore throat for a long time in the morning. Yellowish plugs are found on the hyperemic tonsils. In this case, a different treatment is prescribed.

Transition to chronic form

A patient who has suffered acute tonsillitis does not have strong immunity to the disease. It is easy to become infected again, especially when treated on your own. An untreated infection is worse, as it leads to the emergence of a permanent source of infection. Bacteria remaining on the surface of the tonsils disrupt the tissue structure. And the absorption of allergens into the blood leads to the tonsils becoming a reservoir of pathogenic bacteria. Hence the constant relapses of sore throat, accompanied by:

• bad breath;
• tingling pain in the throat;
• rapid fatigue;
• constant headache;
• increase in body temperature.

When the symptoms of inflammation of the tonsils do not go away for a long time, it is necessary to select drugs that will be effective in the fight against chronic sore throat. These include antibacterial agents of the macrolide group.

Incorrect use of antibiotics

Treatment with antibiotics should not only continue until the signs of sore throat disappear. Usually, without completing treatment, the patient falls ill again. But at the same time he gets complications that could have been avoided.

Antibacterial agents in the form of tablets are taken for 2 weeks, then the pathogen will be completely suppressed. And the patient will fully recover, avoiding relapse. When carrying out treatment at home, you must strictly follow the doctor’s instructions and do not stop taking the medicine halfway.

Together with antibiotics, it is necessary to use topical agents for sore throat: sprays, solutions. They will wash away pathogenic bacteria found in purulent or serous exudate from the surface of the tonsils.

Antibiotics are used continuously, without interruption. You should not skip taking antibacterial agents.

Re-infection with sore throat

Recurrence of tonsillitis is rare and only with improper treatment. In rare cases, bacteria enter the human body again and cause inflammation of the tonsils. This happens because:

• the body is weakened after suffering from a sore throat;
• the close environment is a source of infection;
• sudden hypothermia occurred;
• Throat irritation begins due to allergies, dust, smoking.

Repeated tonsillitis is an exception to the rule, because a protective barrier remains in the tonsils, and antibodies that fight bacteria are present in the blood. The only complication that can occur after the flu is inflammation of the tonsils. Then it is necessary to select antiviral drugs.

The main problem of long-term angina is that the treatment requirements based on the causative agent of the pathology are not met. After a bacterial infection and taking antibiotics, the body's reaction may be ambiguous. A fungal type disease will replace inflammation caused by bacteria. The symptoms will be similar, but different medications must be selected.

Often during therapy, the patient overdoes it in hot drinks, the throat becomes burned, and this leads to redness of the tonsils. And then the inflammatory process will begin again, because the damaged tonsil tissue will not be able to resist pathogenic microorganisms.

The disease also returns when the throat is irritated by chemicals or mechanical objects. Then the tumor is accompanied by symptoms of infection with elevated body temperature and sore throat when swallowing.

The occurrence of another disease

Often repeated sore throats after treating a sore throat with antibiotics are mistaken for relapses of inflammation. But other infections often occur with symptoms similar to sore throat:

1. Tonsillitis is also caused by bacteria, but the disease affects not only the tonsils, but also neighboring areas of the throat.
2. Pharyngitis is an infection that occurs on the mucous membrane and lymphoid tissue of the pharynx. The cause of the disease will be inhalation of hot or polluted air. Chemicals and dust particles also cause inflammation.
3. Laryngitis will be a complication of respiratory diseases. When it occurs, the mucous membrane of the larynx and vocal cords become inflamed. The viral nature of the infection is noted.
4. Infectious mononucleosis affects children from 3 to 9 years old. Symptoms of the disease lie in damage to the lymphatic system, liver, and spleen. Sore throat is one of the signs of pathology.

If weakness, pain and redness in the throat appear, you should undergo a full examination and not self-medicate.

How to distinguish a sore throat from tonsillitis

Tonsillitis is often confused with tonsillitis, but there are differences in symptoms and course of the disease.

Sore throat is characterized by a rapid onset with high body temperature and muscle aches. Tonsillitis occurs more calmly. The pathologies have the same signs - pain and sore throat, redness of the tonsils. But with tonsillitis, the walls of the throat also swell.

With a sore throat, there are no signs such as nasal congestion or runny nose. Purulent plugs are rarely found on the surface of the tonsils during tonsillitis.

Most often, tonsillitis becomes chronic, while angina is more characterized by an acute form.

Antibacterial agents are used in the treatment of both diseases, but acute purulent inflammation cannot be cured without antibiotics. And the course of tonsillitis can be stopped by other means.

More attention is paid to biostimulants and vitamins in the treatment of chronic tonsillitis. It is advisable to use therapeutic measures and physical procedures in treatment while staying in sanatoriums and resorts. It is important to pay attention to general strengthening procedures.

What to do if a sore throat does not go away after treatment

When the result of treatment for sore throat is not visible, it is necessary to contact specialists for additional examination. Only a thorough examination of biological material and bacterial culture can lead to the identification of the causative agent of the disease.

If the pathological condition is caused by a virus or fungus, then appropriate medications and physiotherapy are selected.

It is necessary to change the drug when the previous drug did not give a positive result when taken.

During the selection of therapeutic measures, not only the type of pathogen is taken into account, but also the patient’s condition and his or her tolerance to certain medications. Determine what level the patient’s defense system is at.

Treatment is prescribed based on laboratory tests. If signs of inflammation do not decrease after taking medications, then it is necessary to differentiate the disease from pathologies with similar symptoms.