Bacterial tonsillitis: prevalence, prediction and treatment by the ECP

Abstract

Sore throat or tonsillitis is not necessarily considered a life-threatening emergency but such calls are received and attended to by the ambulance service. It is believed that this is because a face-to-face assessment is often required as the symptoms of a high temperature, headache, lethargy, vomiting and a stiff neck are far too similar to those of meningitis. With complex telephone triage now being performed by nurses and emergency care practitioners (ECP) on clinical support desks within most emergency operation centres, it is hoped that this complaint could be narrowed down and a more appropriate ECP response despatched. When presented with tonsillitis in the community, it is difficult for the practitioner to establish whether the infection is of a bacterial or viral origin. Learned behaviour would suggest that white exudates on the tonsils deem a bacterial origin and requires antibiotic treatment, but this can sometimes be a self limiting illness and antibiotic treatment is not indicated and will only assist with resistance. This article looks as the incidence of bacterial tonsillitis, tools to predict bacterial tonsilitis, and the correct antibiotic and length of course once established. It also briefly touches on the Department of Health's current consultation on paramedic prescribing rights and how a delayed prescription treatment plan cannot be achieved working under a patient group directive (PGD) when treating bacterial tonsillitis. Abstract published with permission.