Tonsillitis is a painful inflammation of the tonsils, two soft structures located at the back of the mouth. They are large in childhood, and get smaller as we get older. Tonsillitis is a common cause of a sore throat in children between five and 10 years old. It can either be caused by bacteria or viruses, and the treatment depends on what type of infection you have. 

Bacterial tonsillitis

Bacterial tonsillitis is typically caused by a bug and it may be treated with antibiotics, whereas viral tonsillitis can't be treated with antibiotics. The four main features that point towards a bacterial infection are:

• High temperature

• White or yellow patches filled with pus on the surface of the tonsils

• Tender and swollen glands in the neck

• No recent cough

Unless you have at least three of these symptoms, you're unlikely to have a bacterial infection. Your doctor will assess whether you’re likely to have a bacterial infection and if antibiotics are a suitable treatment option.

Viral tonsillitis

Viral tonsillitis is common in young children, who often develop a cough or cold-like symptoms, a sore throat and possibly also sore ears, a headache or a tummy ache. There isn't usually a yellow or white coating to the tonsils, but the throat may look sore and red, and the tonsils may look swollen. This type of tonsillitis tends to get better on its own, but symptoms can last around a week. 

Treatment of tonsillitis

Although it's important to only use antibiotics for bacterial tonsillitis, the symptoms of both types can be managed in the same way. Here are a few things that may help:

• Children should get plenty of rest

• Tonsillitis is contagious, so children who have it may need a few days away from other children, especially those who are already unwell

• If eating is a problem, consider soft foods like jelly and ice cream, which are easier to swallow with a sore throat. If your child is unable to eat anything, or cannot manage to drink enough fluids because of their sore throat, take them to the GP

• Give your child cool drinks to help soothe the throat

• Painkillers such as paracetamol and ibuprofen can be helpful in reducing fever and managing pain, but avoid giving children under 16 years of age aspirin

• Sore throat treatments, such as lozenges, mouthwashes and throat sprays can help numb the back of the throat and ease pain. Speak to your pharmacist for advice, as some of these products are only suitable for children of certain ages. Make sure you also read the patient information leaflet that comes with the product

• If your child gets recurring bouts of severe tonsillitis, consult your doctor. Some children eventually need to have their tonsils surgically removed. Your GP is the best person to advise whether your child would benefit from this as it's no longer common

Next steps

• Most cases of tonsillitis are viral, but if you have any symptoms that may indicate bacterial tonsillitis, such as white spots which are filled with pus on your tonsils at the back of your throat, see your GP

• Symptoms should last three to four days. See your GP if you're still ill after four days

• Symptoms can usually be managed at home with self-help measures and painkillers