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Key takeaways
Antibiotics can help treat swollen lymph nodes when they’re caused by a bacterial infection, but not a viral infection, since antibiotics only target bacteria.
Common antibiotics for bacterial infections include penicillins, cephalosporins, macrolides, fluoroquinolones, and tetracyclines.
Antibiotics start working right away, but it typically takes a few days or weeks to see a significant reduction in symptoms.
Every person has around 600 lymph nodes, according to the National Institutes of Health. These groups of nodes act like tiny Brita filters, storing white blood cells and eliminating potentially harmful foreign substances. When these nodes swell up, it’s a natural immune system response to illness. It shows that they’re working to clear infections from the body.
Typically, treating swollen lymph nodes (lymphadenopathy) means treating the underlying cause. Antibiotics can help, but it depends entirely on the type of illness that’s causing the swelling. Here’s all the important information.
Do antibiotics help with swollen lymph nodes?
They can, but only in certain cases.
The most common cause of lymph node swelling is infection—often an upper respiratory infection, the common cold, influenza, sinus infections, strep throat, tonsillitis, or infectious mononucleosis. Sometimes the lymph nodes themselves can become infected (lymphadenitis).
Along with symptoms like sore throat, runny nose, or fever, these infections may cause the lymph nodes on the side of the neck, jaw, and chin to become enlarged, tender, or painful to the touch. Illnesses can sometimes cause lymph node inflammation in another part of the body—like the armpit, ear, leg, or groin areas—but the swelling is often close to the site of an infection.
When the infection is bacterial, antibiotics can help. “A partial treatment that incorporates the use of antibiotics is suitable only if its cause is a bacterial infection, such as streptococcal pharyngitis (strep throat) or bacterial lymphadenitis,” says Dr. Michael Chichak, MD, medical director at MEDvidi. “Antibiotics will never be useful if a viral infection, like the ones caused by common colds or mononucleosis, is the underlying cause.”
Per Dr. Edmond Hakimi, DO, medical director at Wellbridge, “if it is something viral—like a cold or the flu—antibiotics will not help because they only work against bacterial infections, not viruses. In those cases, your lymph nodes typically go down on their own once your immune system clears things up.”
These drugs stop the bacteria from spreading by attacking their cell walls or inhibiting their ability to multiply, per the Nature Reviews Microbiology. So if the healthcare provider suspects strep throat, tuberculosis, cat-scratch fever, skin infections, or other bacterial health conditions, they may prescribe an antibiotic. People whose enlarged lymph nodes come from a virus like a cold or flu, however, will see more success with antiviral medications or getting rest while the infection runs its course.
Rarer possible causes of swollen lymph glands include injuries, certain medications, human immunodeficiency virus, autoimmune disorders like rheumatoid arthritis, or cancer (like leukemia). The healthcare provider will develop a treatment plan specifically to suit the cause.
What are the best antibiotics for swollen lymph nodes?
When lymphadenopathy comes from a bacterial infection, antibiotic therapy is one of the most common treatment options. The particular antibiotic that works best depends on the type of infection, the patient’s medical history, and other medications they’re taking.
That said, some of the most commonly prescribed antibiotics for bacterial infections include:
- Penicillins: Medicines like amoxicillin and ampicillin prevent bacteria from creating cell walls.
- Cephalosporins: These drugs, like cephalexin, cefadroxil, work similarly to penicillins.
- Macrolides: Azithromycin, clarithromycin, and other macrolides inhibit the synthesis of certain proteins, preventing bacterial growth.
- Fluoroquinolones: Antibiotics like ciprofloxacin, levofloxacin work by stopping the bacteria from creating DNA.
- Tetracyclines: Doxycycline, minocycline, and other tetracycline antibiotics prevent the bacteria from synthesizing certain proteins.
These classes of antibiotics are popular because they’re all versatile drugs that can treat a wide range of medical conditions. The doctor will select the one that best fits your particular circumstances, and once the infection has cleared up, the swelling should gradually subside. If it doesn’t, pay another visit to the doctor.
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How long do antibiotics take to treat swollen lymph nodes?
Most antibiotics start working shortly after you take them, and some people might start noticing a difference right away. However, it typically takes a few days or weeks after treatment for significant changes in swelling.
“The duration for swollen lymph nodes to resolve depends on the individual’s immune response in conjunction with the infection’s severity,” Dr. Chichak says. “Typically, once the underlying infection begins to resolve, the improvement in the swelling of the lymph nodes is usually observed within a week.”
For example, a study on people with acute bacterial sinusitis showed that the median time for a 50% reduction in symptoms was five days for people on amoxicillin-clavulanate and four days for people taking telithromycin. The median time for a 75% reduction was eight days for amoxicillin-clavulanate and seven days for telithromycin. Research also shows that shorter courses of antibiotic treatment could be as effective as longer ones for some infections.
These studies don’t look specifically at swollen glands, but since it’s one of the common signs of these infections, they might follow a similar timeline. However, in some cases, it might take multiple weeks for the nodes to return to normal size after the pain subsides, according to University of Florida Health. “The key is to take the entire course—even if you feel better halfway through—so the infection does not bounce back,” Dr. Hakimi says.
Most cases are nothing to worry about, so it’s typically not a medical emergency. However, “if your lymph nodes stay swollen for more than a couple of weeks or get bigger or more painful, it’s a good idea to check in with your doctor,” Dr. Hakimi continues. “Sometimes, lingering swelling just takes time, but we always want to rule out anything more serious.”