{"id":4362,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/recurrenttonsillitispaeds\/"},"modified":"2026-10-26T08:14:28","modified_gmt":"2026-10-26T08:14:28","slug":"recurrenttonsillitispaeds","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/paediatrics\/paediatric-ent\/tonsils-paediatrics\/recurrenttonsillitispaeds\/","title":{"rendered":"Recurrent Tonsillitis"},"content":{"rendered":"\n<title>Recurrent Tonsillitis Paeds<\/title>\n\n\n\n<p class=\"wp-block-paragraph\">Most sore throats are due to a viral infection.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Acute bacterial tonsillitis is more likely if there are tender and enlarged anterior cervical lymph nodes, fever and absence of coryzal symptoms.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If acute bacterial tonsillitis is suspected, and treatment opted for, the standard is Phenoxymethylpenicillin orally. See: <a href=\"https:\/\/cks.nice.org.uk\/topics\/sore-throat-acute\/\" target=\"_blank\" rel=\"noreferrer noopener\">Sore throat &#8211; acute | Health topics A to Z | CKS | NICE<\/a> for advice about decision to treat.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C.M &amp; G.T 23-10-26<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who to refer<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>The decision to refer should be based on the frequency and severity of the infections.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>We can only accept referrals for consideration of tonsillectomy for patients who meet the following criteria<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Recurrent sore throats present for a period of over 1 year<\/li>\n\n\n\n<li>7 infections in 1 year<\/li>\n\n\n\n<li>5 infections\/year for 2 consecutive years<\/li>\n\n\n\n<li>3 infections\/year for 3 consecutive years<\/li>\n\n\n\n<li>Significant impact on child\u2019s education\/school attendance or parental attendance at work.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><u>Emergency referral:<\/u><\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Refer to the A&amp;E if suspicious of quinsy (peritonsillar abscess) or airway compromise<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<ul class=\"wp-block-list\">\n<li>Long term prophylactic antibiotic therapy is not recommended<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/www.entuk.org\/_userfiles\/pages\/files\/guidelines\/Revised%20ENT%20UK%20Tonsillectomy%20commissioning%20guide%20edit%20to%20final%20(002).pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Revised ENT UK Tonsillectomy commissioning guide edit to final.pdf<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2023\/10\/decision-support-tool-making-a-decision-about-recurrent-tonsillitis-in-children-and-adults.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">NHS_Recurrent_tonsillitis_decision_aid<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.nice.org.uk\/guidance\/ng84\" target=\"_blank\" rel=\"noreferrer noopener\">Overview | Sore throat (acute): antimicrobial prescribing | Guidance | NICE<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/cks.nice.org.uk\/topics\/sore-throat-acute\/\" target=\"_blank\" rel=\"noreferrer noopener\">Sore throat &#8211; acute | Health topics A to Z | CKS | NICE<\/a><\/li>\n<\/ul>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Recurrent Tonsillitis Paeds Most sore throats are due to a viral infection. Acute bacterial tonsillitis is more likely if there are tender and enlarged anterior cervical lymph nodes, fever and absence of coryzal symptoms. If acute bacterial tonsillitis is suspected, and treatment opted for, the standard is Phenoxymethylpenicillin orally. See: Sore throat &ndash; acute |<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":22506,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[182],"class_list":["post-4362","page","type-page","status-publish","hentry","category-recurrenttonsillitis"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/entpaediatric\/recurrenttonsillitis\/\" rel=\"tag\">Recurrent Tonsillitis (Paeds)<\/a>","rttpg_excerpt":"Recurrent Tonsillitis Paeds Most sore throats are due to a viral infection. Acute bacterial tonsillitis is more likely if there are tender and enlarged anterior cervical lymph nodes, fever and absence of coryzal symptoms. If acute bacterial tonsillitis is suspected, and treatment opted for, the standard is Phenoxymethylpenicillin orally. See: Sore throat &ndash; acute |","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4362","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4362"}],"version-history":[{"count":3,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4362\/revisions"}],"predecessor-version":[{"id":30562,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4362\/revisions\/30562"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/22506"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4362"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4362"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}