From the Guidelines
Augmentin (amoxicillin-clavulanic acid) is not the first-line treatment for bacterial tonsillitis, and penicillin or amoxicillin are preferred options. According to the American Heart Association guidelines 1, the recommended treatment for streptococcal tonsillopharyngitis includes penicillin V, amoxicillin, or benzathine penicillin G.
- The dosage for amoxicillin is 50 mg/kg once daily (maximum 1 g) for 10 days, which is a more suitable option for bacterial tonsillitis.
- Penicillin V is recommended at a dose of 250 mg 2 to 3 times daily for children under 27 kg (60 lb), and 500 mg 2 to 3 times daily for children over 27 kg (60 lb), adolescents, and adults, for a duration of 10 days.
- Benzathine penicillin G is also an option, with a dose of 600 000 U for patients under 27 kg (60 lb) and 1 200 000 U for patients over 27 kg (60 lb), administered intramuscularly once. For individuals allergic to penicillin, narrow-spectrum cephalosporins, clindamycin, azithromycin, or clarithromycin may be considered as alternative treatments 1.
- It is essential to note that Augmentin (amoxicillin-clavulanic acid) is not listed as a recommended treatment option in the guidelines, and its use may not be necessary for bacterial tonsillitis unless there is a specific indication, such as a beta-lactamase-producing organism.
- Patients should complete the entire course of antibiotics as prescribed, even if symptoms improve before completion, to prevent recurrence and antibiotic resistance.
- It is also important to stay hydrated, use throat lozenges or warm salt water gargles for symptomatic relief, and take the medication with food to minimize gastrointestinal side effects.
- If symptoms worsen or do not improve within 48-72 hours, patients should contact their healthcare provider, as a different antibiotic may be needed.
From the Research
Treatment for Bacterial Tonsillitis
- Bacterial tonsillitis is typically caused by group A beta-hemolytic streptococcus (Streptococcus pyogenes) and can be treated with antibiotics 2.
- The first-line antibiotic for treating group A beta-hemolytic streptococcus is penicillin, but other antibiotics like amoxicillin-clavulanic acid (Augmentin) can also be effective 2, 3, 4.
Use of Augmentin for Tonsillitis
- Augmentin (amoxicillin-clavulanic acid) has been shown to be effective in treating acute streptococcal tonsillopharyngitis, with a high therapeutic efficacy comparable to other antibiotics like penicillin 3, 5, 4.
- A study found that Augmentin was more effective than penicillin in eradicating group A beta-hemolytic streptococci from the tonsils of patients with recurrent tonsillitis 4.
- Another study found that amoxicillin-clavulanic acid (Augmentin) had a higher safety profile and was more effective in treating acute streptococcal tonsillopharyngitis compared to other forms of amoxicillin-clavulanic acid 5.
Comparison with Other Antibiotics
- A systematic review found that clindamycin and amoxicillin with clavulanate (Augmentin) were superior to penicillin in treating recurrent acute pharyngo-tonsillitis, with preferable effects on the microbiological flora and the number of future attacks 6.
- Another study compared the efficacy of clarithromycin, amoxicillin-clavulanate, and penicillin V in treating group A streptococcal tonsillopharyngitis, and found that amoxicillin-clavulanate and penicillin V were more effective than clarithromycin in eradicating the bacteria 3.