In the past, more serious bacterial infections also caused tonsillitis. These include diphtheria and scarlet fever. Immunizations and improved antibiotics have reduced the role of these bacteria. Tonsillitis is treated by a combination of supportive measures to relieve the symptoms and medicine against the organisms causing the infection. Supportive measures include increased fluid intake, anti-inflammatory medications and gentle salt water gargles.
Antibiotics are effective against bacterial infections.
Penicillin is still effective against many of the infectious organisms, though some bacteria have developed resistance to this medicine and stronger antibiotics must be used. Viral infections are not affected by antibiotics, and unnecessary use of antibiotics can actually make the situation worse. These infections are best treated by supportive measures alone. Very severe infections require hospitalization. Inability to swallow can lead to dehydration that is best treated with intravenous fluid.