Tonsillitis: Symptoms, Antibiotics & Online Doctor in the UK
Educational information — not medical advice.
This article was prepared by the OnlineDoctor24 editorial team and reviewed for factual accuracy against UK clinical guidance (NHS and NICE). It is not written by a doctor and does not replace personal medical advice. For symptoms specific to you, book an online doctor consultation.
Key points
- Tonsillitis is inflammation of the tonsils, often viral but sometimes bacterial.
- Bacterial tonsillitis (often Group A Strep) usually has high fever, pus on tonsils and tender neck glands without cough.
- GPs use the FeverPAIN score to decide whether antibiotics are likely to help.
- Most cases settle in a week with paracetamol, fluids and rest.
- An online doctor can assess on video and prescribe antibiotics when appropriate.
What is tonsillitis?
Tonsillitis is inflammation of the two tonsils at the back of the throat. It is one of the most common reasons UK adults and children seek medical advice. Around 70% of cases are viral, with the rest caused by bacteria — most often Group A Streptococcus.
Symptoms
- Severe sore throat, worse on swallowing
- Red, swollen tonsils, often with white spots or pus
- High fever (often >38.5°C in bacterial cases)
- Tender, swollen lymph glands in the neck
- Bad breath, headache, earache
- Tiredness and feeling unwell
FeverPAIN and Centor — how GPs decide on antibiotics
UK GPs use validated scores to estimate how likely a sore throat is bacterial. FeverPAIN awards 1 point for each of: fever in last 24h, pus on tonsils, attendance within 3 days of onset, severely inflamed tonsils, and no cough/coryza. Scores of 4–5 suggest high bacterial likelihood and antibiotics are usually offered.
Self-care
- Paracetamol or ibuprofen for pain and fever.
- Plenty of fluids and soft, cool foods.
- Salt-water gargles or medicated lozenges.
- Rest and avoid smoking.
When an online doctor can help
An online GP can apply a FeverPAIN score during your video consultation and prescribe phenoxymethylpenicillin (or clarithromycin if penicillin-allergic) when bacterial tonsillitis is likely. They can also issue a sick note and refer to ENT if you have recurrent attacks (typically 7+ in a year, 5/year over 2 years, or 3/year over 3 years).
Red flags — when to seek urgent help
Call 999 or go to A&E if you experience any of the following:
- Difficulty breathing or swallowing your own saliva
- Drooling, muffled 'hot potato' voice
- Severe one-sided pain with swelling (possible quinsy / peritonsillar abscess)
- Stiff neck or rash (possible scarlet fever or meningitis)
- Symptoms lasting more than a week or worsening
Frequently asked questions
Common questions UK patients ask about tonsillitis.
How an online doctor can help
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This article is for general information only and does not replace personal medical advice from a qualified doctor. Content is reviewed against UK NHS and NICE guidance by the OnlineDoctor24 editorial team and is not authored by a medical doctor. If your symptoms worsen or you are unsure, please book a consultation with a GMC-registered GP.
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