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Clinical Practice Guideline: Tonsillectomy in Children (Update)

Clinical Practice Guideline: Tonsillectomy in Children (Update)

This guideline was published as a supplement in the February 2019 issue of OtolaryngologyHead and Neck Surgery.

This clinical practice guideline (CPG), which is intended for all clinicians in any setting who interact with children aged 1 to 18 years who may be candidates for tonsillectomy, is an update of, and replacement for, the prior CPG that was published in 2011. The purpose of this multidisciplinary CPG is to identify quality improvement opportunities in managing children under consideration for tonsillectomy and to create explicit and actionable recommendations to implement these opportunities in clinical practice. Specifically, the goals are to educate clinicians, patients, and/or caregivers regarding the indications for tonsillectomy and the natural history of recurrent throat infections. 

Update Leadership: Ron B. Mitchell, MD (Chair), Sanford M. Archer, MD (Assistant Chair), Stacey L. Ishman, MD, MPH (Methodologist), Richard M. Rosenfeld, MD, MPH, MBA (Consultant).

Guideline Update Group: Sarah Coles, MD; Sandra A. Finestone, PsyD; Norman R. Friedman, MD, DABSM; Terri Giordano, DNP, CRNP, CORLN; Douglas M. Hildrew, MD; Tae W. Kim, MD; Robin M. Lloyd, MD; Sanjay R. Parikh, MD; Stanford T. Shulman, MD; David L. Walner, MD; Sandra A. Walsh, BS; and Lorraine C. Nnacheta, MPH.

The CPG is Endorsed By: 
American Academy of Family Physicians (AAFP)
American Academy of Sleep Medicine (AASM)
The American Society of Pediatric Otolaryngology (ASPO)
Infectious Diseases Society of America (IDSA)
Society of Anesthesia and Sleep Medicine (SASM)
The Society of Otorhinolaryngology and Heck-Neck Nurses (SOHN)
The Society of Pediatric Anesthesia (SPA)
The Triological Society

The American Society of Anesthesiologists’ (ASA) Administrative Council has approved endorsement. Since the document has neither been presented nor approved by either the ASA Board of Directors or House of Delegates, it is not an official or approved statement or policy of the Society.


For Patients

In 2012 the ABIM Foundation launched Choosing Wisely® with a goal of advancing a national dialogue on avoiding wasteful or unnecessary medical tests, treatments and procedures.

Choosing Wisely centers around conversations between providers and patients informed by the evidence-based recommendations.

Access the AAO-HNSF Choosing Wisely List of 10 Things Providers and Patients Should Question

Oral antibiotics may have significant adverse effects and do not provide demonstrable benefit after tonsillectomy. Avoidance of oral antibiotics can reduce the spread of antibiotic resistance and the risk of opportunistic infections.