The American Academy of Otolaryngology-Head and Neck Surgery urges patience in the treatment of moderate throat infections in a new multidisciplinary clinical practice guideline.
Tonsillectomy can improve the quality of life in patients who present with 7 documented severe throat infections in the previous year, 5 infections in the past 2 years or 3 infections per year over the last 3 years, notes the guideline, which defines severe infections as those marked by fevers of 101ºF or higher, swollen or tender neck glands, exudates on the tonsils or positive strep throat tests.
More moderate infections typically resolve on their own and warrant a "watchful waiting" treatment approach, says the guideline, which appears in the January issue of the AAO-HNSF's official scientific journal. In these cases, tonsillectomy should not be performed until a period of observation is completed.
However, the guideline notes that certain factors might still warrant tonsillectomy in patients suffering from moderate infections, including antibiotic allergy or intolerance, a history of peritonsillar abscess, or periodic fevers, aphthous stomatitis, pharyngitis and adenitis (PFAPA syndrome).
The recommendation also directs caregivers to:
Richard M. Rosenfeld, MD, MPH, one of the guideline's authors, hopes the report will empower doctors and parents to make the best decisions related to the treatment of throat infections, "resulting in safer surgery and improved quality of life for children who suffer from large or infected tonsils."
