Acute Pharyngitis (Tonsillitis) Pediatric Care Plan

By David Shafran, MD
Medically reviewed
December 27, 2020

What is Acute Pharyngitis?

Acute pharyngitis is a throat infection involving the tonsils and/or back of the throat. In children, throat infections are more commonly caused by bacteria like strep. This means that antibiotics don’t help.

Most of the time, your provider can determine if a strep test is needed just by taking your child’s history and doing a basic physical exam. 

Sore throats are common at any age and can be one of the first signs of another illness, like a cold, the flu, or mononucleosis (mono). Other symptoms of acute pharyngitis include:

  • Fever
  • Runny nose
  • Cough
  • Hoarse voice
  • Body aches

Acute Pharyngitis Treatment

Since most of the time acute pharyngitis is viral, antibiotics are not needed. Supportive care and time are all that’s needed. Here are some suggestions.

General

  • Make sure your child drinks lots of fluid, eating is not as important
  • Make sure your child rests a lot
  • Tylenol or motrin for general discomfort

Sore Throat

  • Give hard candy or cough drops to relieve sore throat (only for kids older than 6)
  • Sip warm chicken broth. 
  • Some children prefer cold foods such as popsicles or ice cream.
  • Warm salt water gargles
  • Tylenol or motrin dosed appropriately

Nasal Congestion and Cough

  • Decongestant and cough medications have not been proven to be effective and are generally not recommended
  • Run a cool humidifier 
  • Use saline (salt water) nose drops or spray to loosen up the dried mucus. If you don’t have saline, you can use a few drops of bottled water or clean tap water.
  • Run a hot shower to create a steam-filled bathroom where your child can sit to help clear stuffiness
  • For children 8 years of age and older, saline sinus irrigation can provide better relief of congestion.

How Do I Know If It’s Strep?

As a rule, most throat infections are not strep and are usually caused by a virus. Even if your child’s only symptom is sore throat, it’s still most likely a virus.

If your child has cold symptoms along with a sore throat, they should not be tested. If, however, they just have a fever and sore throat or stomach ache with throat redness or pus, they might be tested. 

How Do I Know It’s Not COVID?

The short answer is you can’t for sure. The only way to know for sure is through testing which, usually, your child’s provider can order

When Can My Child Return to School?

  • When they haven’t had a fever for 24 hours without the help of tylenol or motrin
  • When they’re feeling better
  • Your child’s school may require either a symptoms free child and 10 days since the onset of symptoms OR a negative COVID test

Check In With K If…

  • You need help evaluating how sick your child is
  • You’re looking for advice about supportive care
  • You have any questions about throat infections

See a Doctor In Person If…

  • Your child’s pain becomes severe
  • Symptoms last for more than 5 to 7 days
  • Your child has difficulty swallowing or is drooling excessively
  • You think your child needs to be seen
  • Your child isn’t drinking enough to stay hydrated
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

David Shafran, MD

Dr. Shafran is a board-certified pediatrics physician. He joins K Health from the Cleveland Clinic, where he led a pediatrics practice and completed a fellowship in transplant ethics. He has completed multiple fellowships, including one in pediatric nephrology at Rainbow, Babies & Children's University Hospitals. He received his medical degree from the Sackler School of Medicine in Tel Aviv and completed his medical residency at the Jacobi Medical Center.