hello paul and welcome to health care magic, It is difficult I know when you do have so much pain and the medications do not help much. The antibiotics usually take a couple of days to be effective and if you feel that the relief is not very good then you must either change your antibiotic after a throat swab or take injectable medications for better and faster pain relief. Tramodol is very effective in all types of pain and it can be very well taken for good relief with ibuprofen but the combination of tramodol with paracetamol is more preferred. In any case it is recommended that you take any medication in consultation with your doctor. Take warm water and like i mentioned before if you are not feeling better then you must take a throat swab and consult an ENT surgeon regards Dr Sriram nathan