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Swollen Tonsils, Pus On Tonsils, Low Grade Fever, Fatigue. More Pus After Taking Amoxicillin. What To Do?

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Posted on Sun, 26 Aug 2012
Question: Hi! I've recently been diagnosed with strep (2 days ago) and have been experiencing symptoms (swollen tonsils, pus on tonsils, low grade fever, fatigue) for over 7 days now. The doc did not actually do a culture test. But I did receive a prescription for amoxicillin 850mg one every 12 hours. I have taken the prescription for two days and things don't seem to be getting better. If anything, there is MORE pus.

Is the pus and indicator of things healing?
Do I need to return to the doc and get a different prescription?

I'm worried that I'm just being impatient. Should I give the antibiotics more time? I have had a history of tonsil and URIs for which I've taken a few courses of antibiotics. Could I potentially be immune to the effects of the amoxicillin?
doctor
Answered by Dr. Ram Choudhary (2 hours later)
Hi XXXXXX,
Welcome to healthcare magic Physician's desk!
I have seen the image of your tonsils, there is no doubt that you are having Acute Tonsillitis.
It must be quite painful, you should take tab. Ultracet 6 hourly to soothe pain.
You need good oral oral hygiene, brush twice a day and post brush do the betadine/chlorhexidine mouth gargles and the do not take anything for coming 2hours.
You need Tab. AUGMENTIN 625MG thrice a day and
Tab. LEVOFLOXACIN 500MG once daily
all for 7 days and then review.
You should get a blood culture and sensitivity and Throat swab gram stain and culture sensitivity before starting the treatment.
I think the advise would be helpful for you.
I wish you a great health!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ram Choudhary (1 hour later)
Okay... So that didn't really answer my questions. I

'm already on amoxicillin/augmentin 825mg 2x daily. is that not enough? Should I continue to wait for results? I ask because my doctor visits are $500 a pop and I can't afford to go in just to be told to wait it out.

I'm currently using ibuprofen and a phenol spray to manage pain.

Since taking the antibiotics, there has been an increase in pus on the tonsils. Is that an indicator that things are getting better? (pus being white blood cells and reparative and all). Inflammation has not changed, or if it has, not by much.



doctor
Answered by Dr. Ram Choudhary (23 hours later)
Hi XXXXXX,

Welcome back to healthcare magic Physician's desk!
I wanted to advise you that you should take Augmentin(amoxicillin + Clavulanic acid) rather than amoxicillin plain and should take it 8 hourly which is more effective than 12 hourly dosing.
Your disease is quite extensive so you should add Levofloxacin also.
The whitish patches do not suggest improvement but they indicate severity of disease.
You can not see the white cells with naked eyes. The whitish patch is formed by dead tissue, bacteria, and dead WBCs.
Please take the treatment I have advised in the supervision and knowledge of your clinician.

I think the advise would be helpful for you.

If really satisfied with my solution then please accept the answer and take a moment to express your feelings in the Review Section about my Clinical skills!

Wish you a great XXXXXXX
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ram Choudhary

Internal Medicine Specialist

Practicing since :2001

Answered : 2270 Questions

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Swollen Tonsils, Pus On Tonsils, Low Grade Fever, Fatigue. More Pus After Taking Amoxicillin. What To Do?

Hi XXXXXX,
Welcome to healthcare magic Physician's desk!
I have seen the image of your tonsils, there is no doubt that you are having Acute Tonsillitis.
It must be quite painful, you should take tab. Ultracet 6 hourly to soothe pain.
You need good oral oral hygiene, brush twice a day and post brush do the betadine/chlorhexidine mouth gargles and the do not take anything for coming 2hours.
You need Tab. AUGMENTIN 625MG thrice a day and
Tab. LEVOFLOXACIN 500MG once daily
all for 7 days and then review.
You should get a blood culture and sensitivity and Throat swab gram stain and culture sensitivity before starting the treatment.
I think the advise would be helpful for you.
I wish you a great health!