Do antibiotics work for tonsillitis caused by infectious mononucleosis?

Report By: Helen Slee - medical student
Search checked by Professor Mackway Jones - Consultant
Institution: MRI
Date Submitted: 11th July 2005
Last Modified: 14th July 2005
Status: Blue (submitted but not checked)

Three Part Question

In [an adult with acute tonsillitis caused by infectious mononucleosis] are [antibiotics better than conservative management] at [reducing pain and length of symptoms]?

Clinical Scenario

An 18 year old male with known infectious mononucleosis presents with sore throat, anterior cervical lymphadenopathy, fever and tonsillar exudates. The SHO wonders if antibiotics would help?

Search Strategy

Medline 1966 to June Week 1 2005
Embase 1980 to 2005 Week 24
Cinahl Cumulative Index to Nursing & Allied Health Literature 1982 to June Week 1 2005
The Cochrane Library Issue 1 2005
{Tonsillitis.mp. OR exp TONSILLITIS/} AND {infectious mononucleosis.mp. OR glandular fever} AND {antibiotics.mp. OR antibacterials.mp OR exp Anti-Bacterial Agents/} AND {conservative treatment.mp. OR conservative management.mp. OR (conserve$ adj5 treat$).af. OR (conserve$ adj5 manage$).af.}

Search Outcome

Medline -no papers found
Embase-1 irrelevant paper found
Cinahl-no papers found
Cochrane-6 papers found-none relevant

Comment(s)

There were no papers found. It may be assumed that if a patient has infectious mononucleosis and tonsillitis, the infective agent is the Epstein Bar virus. Therefore antibiotic treatment or further investigation is unneccessary.

Clinical Bottom Line

No evidence was found, follow local policy.