New Treatment Guidelines for Sore Throat Infections

New guidelines for treating sore throat infections have been recommended in an effort to reduce the number of potentially unnecessary tonsillectomies administered to children each year.

The new evidence-based guidelines from the American Academy of Otolaryngology- Head and Neck Surgery Foundation (AAO-HNSF) are intended to provide better guidance to pediatric ear, nose and throat clinicians when determining whether tonsil removal is the appropriate treatment for patients with sore throat infections.

The guidelines also include recommendations on enhancing pre- and post-treatment care, as well as methods aimed to improve counseling and education of families considering tonsillectomy surgery for their child.

A tonsillectomy is a surgical procedure in which both tonsils are removed from their location in the throat near the base of the tongue. Tonsillectomies are one of the most common surgical procedures conducted in the United States; with more than half a million performed annually on children younger than 15 years old.

Tonsils are most commonly removed due to frequent throat infections or sleep-disordered breathing (SDB). A tonsillectomy sometimes includes the removal of the adenoid, - a lump of tissue located above the tonsils near the back of the nose - especially in SDB patients.

According the new guidelines, children most likely to benefit from tonsillectomies are those with at least:

• Seven documented cases of severe throat infection over the course of a year.


• Five severe throat infections annually for two consecutive years.


• Three severe throat infections annually for three consecutive years.

The new guidelines describe a patient meeting the criteria for a severe sore throat infection diagnosis as one who tests positive for strep throat or has all of the following: A fever of 101 degrees Fahrenheit, swollen/tender neck glands and a white covering over the tonsils.

Typically, children with frequent throat infections are able to adequately recover without tonsil removal. However, the AAO-HNSF stresses that children with less frequent or severe infections might still benefit from a tonsillectomy if factors such as antibiotic allergy are present.

Other notable points included in the AAO-HNSF report:

• Obstructed breathing due to large tonsils can cause SDB, possibly resulting in snoring, mouth breathing, pauses in breathing or sleep apnea. A tonsillectomy might resolve growth delay, poor performance at school, bedwetting or other problems sometimes experienced by children with SDB or large tonsils.


• Children with SDB that are obese or suffering from head and neck-related syndromes might require further management following a tonsillectomy.


• Parents should be informed about pain management approaches appropriate for use on children following tonsillectomy surgery. Acceptable methods include consuming plenty of liquids and using acetaminophen or ibuprofen. Parents should also make sure to receive updates from their child as to whether they are experiencing any pain in their throat.

For more information on the best sore throat infection treatment for your child, consult your pediatric otolaryngologist.