A patient presents with fever, sore throat, and dysphagia.

Differential Diagnosis

• Pharyngitis
• Tonsillitis

Important Note

If a greyish, membranous covering is present over the tonsils:

1. It may indicate membranous tonsillitis, which is manageable.
2. If highly contagious with systemic symptoms, consider diphtheria, which can be lethal.
3. Immediate referral to an ENT consultant is advised for diphtheria anti-toxin administration.

Management For Adults

Medical management is similar to pharyngitis

Category	Medication Name	Generic Name	Dosage	Safe in Pregnancy
Antibiotics	Tab. Amoxil	Amoxicillin	500mg(1+1+1)	No
	Tab. Augmentin	Amoxicillin + Clavulanic Acid	625mg(1+1+1)	Yes
	Tab. Azomax / ZYTO	Azithromycin	500mg(1+0+0)	No
	Tab. Cefizil / Caricef	Cefixime	400mg(1+0+0)	No
	Tab. Klaricid / ClariTex	Clarithromycin	250mg(1+1)	No
NSAIDs	Tab. Brufen	Ibuprofen	400mg(1+1)	No
	Tab. Panadol / Calpol	Paracetamol	500mg(2+2+2)	Yes
	Tab. Danzen DS	Serratiopeptidase	10mg(1+1)	No
Anti-Histamines	Tab. Fexet	Fexofenadine	60mg(1+0+0)	No
	Tab. Rigix	Cetrizine dihydrochloride	10mg(1+0+0)	No
	Tab. Jardin	Loratadine	10mg(1+0+0)	Yes

Management For Pediatrics

Category	Medication Name	Generic Name	Strength	Dosage Calculation	1 Year (10 kg)	2-4 Years (≤15 kg)	5 Years (>15 kg)	Contraindications
Antibiotics	Syp. Augmentin	Amoxicillin + Clavulanic Acid	312.5 mg/5ml	30 mg/kg/dose	1 TSF TDS	1½ TSF TDS	2 TSF TDS	No
	Syp. Caricef	Cefixime	100 mg/5ml	10 mg/kg/dose	1 TSF OD	1½ TSF OD	2 TSF OD	No
NSAIDs	Syp. Brufen	Ibuprofen	100 mg/5ml	10 mg/kg/dose	1 TSF TDS	1½ TSF TDS	2 TSF TDS	No
	Syp.calpol	Paracetamol	250 mg/5ml	10–15 mg/dose	1 TSF TDS	1½ TSF TDS	2 TSF TDS	No
Anti Histamines	Syp. Rigix	Cetirizine Dihydrochloride	2.5 mg/5ml	10–15 mg/dose	1 TSF HS	2 TSF HS	2 TSF HS	<6 months

(Other antihistamines: Rigix, Sedil, Neo-Anial)

Important Notes

• Tonsillitis is mostly viral; antibiotics are not always necessary.
• Antiviral medications are generally not required for viral tonsillitis. Virus complete their time of about 7 days and go away. We only give systematic therapy.
• If bacterial, complete the full antibiotic course to prevent resistance.

Counseling & Supportive Care

1. Avoid spicy food, cold drinks, and cold water.
2. Consider tonsillectomy if recurrent episodes of tonsillitis occur.