Anginas, or inflamed tonsils, typically clear up within 7 to 10 days with the right combination of home care and, when needed, antibiotics. The key to getting rid of them quickly is figuring out whether a virus or bacteria is causing the inflammation, because the treatment path is completely different for each.
Most throat infections are viral, meaning antibiotics won’t help. But when bacteria (usually group A strep) are responsible, a course of antibiotics can shorten the illness, reduce pain faster, and prevent complications. Here’s how to tell the difference and what to do in either case.
Viral vs. Bacterial: How to Tell the Difference
About 70 to 80 percent of sore throats with swollen tonsils are caused by viruses. These infections usually come packaged with other cold symptoms: a runny nose, coughing, sneezing, and a hoarse voice. A viral throat infection runs its course in 5 to 7 days, and the main treatment is comfort care while your body fights it off.
Bacterial anginas, most commonly strep throat, look different. Doctors use a scoring system that checks five factors: your age, whether you have a fever, swollen lymph nodes in your neck, white patches or pus on your tonsils, and whether you have a cough. The absence of a cough actually makes strep more likely, not less. If you have a high fever, swollen neck glands, pus on your tonsils, and no cough, the odds of a bacterial infection go up significantly, and a rapid strep test or throat culture is the next step.
You can’t reliably diagnose strep just by looking at your throat. A rapid strep test takes about 10 minutes at a clinic and gives a clear answer.
Home Remedies That Actually Help
Whether your anginas are viral or bacterial, these measures reduce pain and speed healing:
- Salt water gargle. Mix half a teaspoon of salt into one cup of warm water and gargle for 15 to 30 seconds. Repeat several times a day. The salt draws fluid out of swollen tissue, temporarily reducing inflammation and flushing irritants from the throat surface.
- Honey. A spoonful of honey coats the throat and has mild antibacterial properties. Studies have found that honey works about as well as over-the-counter cough suppressants at reducing throat irritation and helping people sleep through the night. Do not give honey to children under one year old.
- Cold and warm fluids. Ice chips, popsicles, and cold water numb sore tissue. Warm broths and teas soothe inflammation. Staying well-hydrated keeps your throat moist and helps thin mucus.
- Humidity. Dry air worsens throat pain. A cool-mist humidifier in your bedroom, especially overnight, can make a noticeable difference.
Over-the-Counter Pain Relief
Ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) are both effective at reducing throat pain and fever. Ibuprofen has the added benefit of reducing inflammation directly, which can help with the swelling of anginas specifically. Adults should stay under 3,200 mg of ibuprofen or 4,000 mg of acetaminophen in a 24-hour period.
If one medication alone isn’t controlling the pain, you can alternate between the two. Take them about three hours apart rather than at the same time. This creates overlapping waves of pain relief without exceeding the safe limits of either drug. Throat lozenges and numbing sprays containing menthol or benzocaine can provide additional short-term relief between doses.
When You Need Antibiotics
If a strep test comes back positive, your doctor will prescribe antibiotics. Amoxicillin or penicillin is the standard choice, typically taken for 10 days. It’s important to finish the full course even if you feel better after a few days. Stopping early allows surviving bacteria to rebound, potentially causing a relapse or complications like rheumatic fever.
If you’re allergic to penicillin, several alternative antibiotics are available. Your doctor will choose one based on the type of allergy you have.
Most people notice significant improvement within 48 to 72 hours of starting antibiotics. You stop being contagious after the first 24 to 48 hours of treatment, which is when you can typically return to work or school. Without antibiotics, strep throat can remain contagious for two to three weeks.
What to Do for Recurring Anginas
Some people deal with anginas multiple times a year. If this is your pattern, it’s worth keeping a record of each episode, including whether you had a fever, visible pus on the tonsils, or a positive strep test. This documentation matters because it determines whether surgery becomes an option.
Tonsillectomy (surgical removal of the tonsils) is considered when throat infections hit a specific frequency: at least seven episodes in one year, at least five episodes per year for two consecutive years, or at least three episodes per year for three consecutive years. Each episode needs to be documented with at least one clinical sign, such as a fever above 101°F, swollen neck glands, tonsillar pus, or a positive strep test.
Tonsillectomy is more commonly performed in children, but adults who meet these criteria can also benefit. Recovery takes about one to two weeks, with significant throat pain for the first several days. Most people see a dramatic drop in the number of throat infections afterward.
Warning Signs That Need Immediate Attention
Most anginas resolve without complications, but a small percentage can develop into a peritonsillar abscess, where a pocket of pus forms behind one of the tonsils. This is a genuine emergency that requires drainage, not just antibiotics.
Watch for these red flags:
- Difficulty opening your mouth. If your jaw feels locked or you can only open partway, the infection may have spread into the tissue around the tonsil.
- One-sided swelling. If one tonsil becomes dramatically larger than the other, or you notice the small tissue hanging at the back of your throat (the uvula) being pushed to one side, an abscess is likely forming.
- Trouble breathing or swallowing saliva. Swelling severe enough to obstruct your airway or make it difficult to swallow your own saliva requires emergency care immediately.
- A sore throat that suddenly gets much worse after initially improving, especially with a rising fever.
A throat that has been sore for more than 10 days without improvement, or that keeps coming back every few weeks, also warrants a visit to your doctor to rule out causes beyond a simple infection.