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Do antibiotics work for tonsillitis caused by infectious mononucleosis?

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
{ OR exp TONSILLITIS/} AND {infectious OR glandular fever} AND { OR OR exp Anti-Bacterial Agents/} AND {conservative OR conservative 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


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.