Clindamycin is then given 300 mg p.o. q 6 hours for a 10 day treatment. We have all been taught to treat tonsillitis for 7-10 days to obviate the sequelae of rheumatic heart disease and glomerulonephritis. The occurrence of post streptococcal glomerulonephritis has essentially disappeared. The incidence of post streptococcal rheumatic heart disease is reduced, compared with 50 years ago, but does still occur. Lastly, if your patient has valvular heart disease, an artificial valve, or any condition which provides a nidus for infection, the tonsil should be swabbed for culture and sensitivity prior to instituting antibiotic therapy.
Throat swabs are highly accurate if properly performed.
Properly performed means swabbing across one tonsil, across the pharynx and across the other tonsil and swabbing sufficiently firmly that bacteria on and in the mucosa are captured by the swab. Too many swabbers simply dab up a little pharyngeal mucus and obtain insufficient material.