1. See a doctor today or tomorrow (ENT specialist or general physician) — do not wait longer with severe swallowing pain. • They will likely: • Do throat swab for rapid strep test or culture (to confirm strep throat) • Examine throat/tonsils/ears • Switch antibiotic if bacterial infection is suspected 2. Likely antibiotic change (doctor will decide): • Amoxicillin 500 mg three times a day × 7–10 days (first choice for strep) • Or Amoxicillin + Clavulanate (Augmentin) if mixed infection/resistance suspected • Azithromycin can be extended to 5 days in some cases, but usually not preferred if no improvement 3. Go to emergency / ENT same day if: • Unable to swallow even saliva (drooling) • Severe difficulty breathing / voice change • High fever (>101°F) returns • Swelling in neck or severe one-sided pain

• Pain relief (very important for swallowing): • Paracetamol 650 mg + Ibuprofen 400 mg together every 6–8 hours (after food) — reduces pain & inflammation better than either alone • Warm salt water gargle (1 tsp salt in 200 ml warm water) — 4–5 times/day • Betadine gargle or Chlorhexidine mouthwash (Hexidine) — 2–3 times/day (diluted as per bottle) • Soothing remedies: • Sip warm water + honey + few drops lemon frequently • Chew ice cubes or take cold milk/ice cream slowly — numbs throat temporarily • Throat lozenges (Strepsils, Vicks, Dorithricin) — every 2–3 hours • Diet & rest: • Only soft, cool foods (khichdi, curd rice, dal-rice, banana, soup, idli) • Avoid spicy, hot, sour, fried food completely • Speak less, rest voice • Sleep with head slightly elevated (2 pillows) Severe pain on swallowing after azithromycin usually means you need stronger/longer antibiotic + symptomatic relief. Please see a doctor today/tomorrow — they will most likely give a 7–10 day course of amoxicillin or similar + pain control. If you want specific brand names in India or if symptoms worsen (fever, unable to swallow saliva), consult online with update. Take care and get well soon