Sore throat, fever, painful tonsils: should you take an antibiotic right away? In the show “It’s going a lot better” on RTL, Dr Jimmy Mohamed, doctor and presenter, clearly answers: no, systematic self-medication is not the right reflex.
Antibiotics and anti-inflammatories: why avoid self-medication
First point recalled in the column: not all tonsillitis are the same. Dr Jimmy Mohamed explains that we often associate angina and antibiotics, while the majority of cases are of viral origin. This order of magnitude is confirmed by Health Insurance, which indicates that tonsillitis is viral in approximately 75 to 90% of cases in adults and 60 to 75% in children.
Practical consequence: an antibiotic is not used to treat viral tonsillitis. It targets bacteria, not viruses. On the other hand, it may be indicated when strep throat A is confirmed, in particular by a rapid diagnostic test, or in a situation assessed by a health professional. The question is therefore not to ban antibiotics, but to not take them “just in case”.
Jimmy Mohamed adds that an unnecessary antibiotic can “damage the intestinal flora”, which he calls the microbiota. On this point, Inserm points out that antibiotic treatment can reduce the quality and quantity of the intestinal microbiota, with recovery varying depending on the situation. Added to this are possible adverse effects and the selection of resistant bacteria.
Second reflex pointed out in the chronicle: anti-inflammatories. Dr Jimmy Mohamed cites ibuprofen, Advil, Voltarene or even ketoprofen, explaining that in the case of bacterial angina, they can promote complications. The wording deserves caution: in case of angina or ENT infection, NSAIDs should be avoided as self-medicationexcept for medical or pharmaceutical advice. Health authorities report a risk of serious infectious complications and a suggested aggravating role, without this meaning that a complication occurs with each dose.
To calm pain or fever, Jimmy Mohamed mentions paracetamol. It is also the analgesic generally preferred in the absence of contraindication, but it requires respecting the instructions and seeking advice in the event of liver disease, allergy, current treatment or special situation. The objective remains the same: relief without multiplying products or masking an abnormal development.
Sprays, lozenges, throat test: what really helps with orientation
Third message of the column: avoid buying “anything and everything” at the pharmacy. Sprays, lozenges and syrups may seem to act directly on angina, but
they don’t treat the causewhether viral or bacterial. Certain products can provide temporary relief, provided that their composition is taken into account. Health Insurance particularly recommends caution with adjunctive treatments for sore throats, especially in children, the elderly or in the event of a history of allergies.
Instead of an accumulation of products, Jimmy Mohamed offers a very simple gesture: honey candies. It does not promote them as a treatment for angina, but as a way to stimulate saliva, which can temporarily soothe the throat. This nuance matters: honey or sweets do not replace a test or medical advice if symptoms worsen or persist.
To go further than feeling, the useful reflex is the throat test. The trained pharmacist can carry out an angina TROD, which mainly looks for group A streptococcal angina. It is this test which helps to distinguish viral angina from bacterial angina and to know if an antibiotic may be necessary. To understand its practical benefit, our file on TROD angina in pharmacies also details its role in treatment.
This test is not a complete diagnosis of all sore throats. It does not replace a consultation when there are signs of seriousness or a particular situation: pregnancy, immunosuppression, young child, very intense pain, difficulty breathing, difficulty swallowing, persistent high fever, frequent recurrences or symptoms that do not resolve. If in doubt about the reflexes to avoid in the event of angina, the pharmacist can refer you to a doctor rather than self-medication.