title: Tonsillectomy versus watchful waiting in recurrent streptococcal pharyngitis in adults: randomised controlled trial.
abstract: OBJECTIVE
  To determine the short term efficacy and safety of tonsillectomy for recurrent streptococcal pharyngitis in adults. Design Randomised controlled trial.
  
  
  METHODS
  Academic referral centre in Finland.
  
  
  METHODS
  70 adults with documented recurrent episodes of streptococcal group A pharyngitis.
  
  
  METHODS
  Instant tonsillectomy (n=36) or remaining on waiting list as control (n=34).
  
  
  METHODS
  Percentage change in the risk of an episode of streptococcal pharyngitis at 90 days. Rates of all episodes of pharyngitis and days with symptoms and adverse effects.
  
  
  RESULTS
  The mean (SD) follow-up was 164 (63) days in the control group and 170 (12) days in the tonsillectomy group. At 90 days, streptococcal pharyngitis had recurred in 24% (8/34) in the control group and 3% (1/36) in the tonsillectomy group (difference 21%; 95% confidence interval 6% to 36%). The number needed to undergo tonsillectomy to prevent one recurrence was 5 (3 to 16). During the whole follow-up, the rates of other episodes of pharyngitis and days with throat pain and fever were significantly lower in the tonsillectomy group than in the control group. The most common morbidity related to tonsillectomy was postoperative throat pain (mean length 13 days, SD 4).
  
  
  CONCLUSIONS
  Adults with a history of documented recurrent episodes of streptococcal pharyngitis were less likely to have further streptococcal or other throat infections or days with throat pain if they had their tonsils removed.
  
  
  BACKGROUND
  Clinical Trials NCT00136877.
authors.affiliation: Department of Otolaryngology, University of Oulu, PO Box 5000, FIN-90014, Finland. opalho@cc.oulu.fi
authors.forename: Olli-Pekka
authors.initials: OP
authors.lastname: Alho
authors.forename: Petri
authors.initials: P
authors.lastname: Koivunen
authors.forename: Tomi
authors.initials: T
authors.lastname: Penna
authors.forename: Heikki
authors.initials: H
authors.lastname: Teppo
authors.forename: Markku
authors.initials: M
authors.lastname: Koskela
authors.forename: Jukka
authors.initials: J
authors.lastname: Luotonen
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D006801:Humans; D008875:Middle Aged; D010612:Pharyngitis / Q000601:surgery*; D012008:Recurrence; D013290:Streptococcal Infections / Q000601:surgery*; D013297:Streptococcus pyogenes; D014068:Tonsillectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome