Strep, diphtheria, and Epstein-Barr infections are all contagious. Unfortunately, some strep bacteria are becoming resistant to penicillin. This means higher doses of amoxicillin or a different antibiotic need to be used. Since antibiotics are not effective against viruses, the only treatment for tonsillitis caused by viral infection is medication to reduce fever and pain. Oral steroids may be given for a short period of time if symptoms are severe.
Oral steroids can lessen the symptoms of tonsiliitis caused by mononucleosis.
Antibiotics can be helpful in preventing infection if material has collected on the surface of the tonsils. In subacute tonsillitis caused by actinomyces, penicillin and clindamycin are effective. If these antibiotics do not work, the person can remove the infected material from the tonsil pits with a finger or special irrigating tool. Otherwise, the tonsils should be removed. In cases of chronic tonsillitis, antibiotics combined with oral steroids may resolve the infection.