A sore throat, not a sore point: evidence-based management of acute tonsillitis

Acute tonsillitis is one of the most common conditions encountered in primary care and places a significant burden on healthcare services. Although the condition is predominantly caused by self-limiting viral infections that require minimal pharmacological intervention, it is frequently misdiagnosed as a bacterial infection, resulting in unnecessary antibiotic prescribing. This inappropriate use of antibiotics contributes to the growing global challenge of antimicrobial resistance (AMR). Healthcare professionals play a critical role in promoting antimicrobial stewardship (AMS) by reducing unnecessary antibiotic use and implementing evidence-based strategies for providing symptomatic relief. Effective management of acute tonsillitis should focus on alleviating key symptoms, including pain, fever, and inflammation, through appropriate pharmacological and non-pharmacological interventions. Furthermore, patient-centred communication regarding the risks and benefits of antibiotic therapy, as well as alternative treatment options, is essential to support informed decision-making and responsible prescribing practices. This clinical review examines the current evidence for the symptomatic management of acute tonsillitis in primary care and highlights practical approaches that support optimal patient outcomes while advancing AMS efforts.