Q. How can recurrent acute tonsillitis be managed?

Answered by
Dr. Shubadeep Debabrata Sinha
and medically reviewed by Dr. Divya Banu M
This is a premium question & answer published on Aug 07, 2020 and last reviewed on: Sep 01, 2020

Hello doctor,

I have acute tonsillitis for the third time this year. My first was last year with white pus, I was prescribed with with Co-Amoxiclav. My second was a month later with white pus, I was prescribed by another doctor with Clindamycin but was not fast and effective as Co-Amoxiclav. Then yesterday. I noticed one of my tonsils in the right side was swollen again. I was nursing this by gargling Hexetidine after every meal. Now I have a slight fever of 37.5 degree. I need help.



Welcome to

Sorry to hear about your health condition. With some rational medicinal therapy, it can be controlled. Tonsillitis has notorious tendency of recurrence and needs longer duration of treatment, particularly if you have immunocompromised disease. It would be advisable to have a throat culture before starting the next antibiotic therapy. However, if you cannot go to a pathology lab, then I would advise the following :

  • Steam inhalation three times a day for 10 days. Salt water gargles (2 teaspoonful in 400 ml warm water = 1 glass) three times a day for 10 days.
  • Tablet Asert CV (Cefixime 200mg + Clavulanic acid 125mg) 1 tablet twice daily (after lunch-after dinner once every 12 hours) for 10 days.
  • Tablet Lymcee 500 mg (Vitamin C) one tablet twice daily (after lunch-after dinner, once every 12 hours ) for 14 days.
  • Tablet Ivercid (Ivermectin) 12 mg 1 tablet once daily (after dinner, once every 24 hours) for 3 days.
  • Tablet Zinconia 50 mg 1 tablet twice daily (after lunch- after dinner, once every 12 hours) for 14 days.
  • Tablet Doxycycline 1 LDR 100 mg 1 tablet twice daily (after lunch-after dinner, one tablet every 12 hours) on day 1 and followed by 100 mg 1 tablet once daily (after lunch, one tablet every 24 hours) for 9 days.
  • Tablet Relent OD (Levocetrizine plus Ambroxol) 1 tablet once daily (after breakfast, one tablet every 24 hours) for 10 days.
  • Tablet Famtac (Famotidine) 40 mg 1 tablet twice daily (after lunch+after dinner, one tablet every 12 hours) for 10 days.
  • Tablet D-Cold Total 1 tablet thrice daily (post- breakfast, lunch dinner, each tablet after 8 hours) for 7 days.
  • Tablet Nucoxia 80 mg (Etoricoxib) 1 tablet SOS.

Please maintain the treatment precisely. Please followup after 5 days.

The Probable causes:

Repeat bacterial infection.

Investigations to be done:

Throat swab before starting antibiotics.

Regarding follow up:

After 5 days.

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