title: Are empiric antibiotics for acute exudative tonsillitis needed in children?
abstract: BACKGROUND
  Empiric antibiotics are frequently given for children with acute exudative tonsillitis. A few studies have investigated the causative agent of acute "exudative" tonsillitis in children to evaluate the necessity of antibiotic therapy. This study tried to explore the common causative agent of acute exudative tonsillitis among children.
  
  
  METHODS
  From April 2009 to March 2010, throat swabs were obtained and cultured for viruses and bacteria from children who visited the pediatric emergency rooms of two medical centers in central Taiwan with acute exudative tonsillitis. Demographic data and microbiological results were analyzed.
  
  
  RESULTS
  A total of 294 children with acute exudative tonsillitis were enrolled during the 1-year prospective study, and 173 (58.8%) of them were younger than 7 years. Group A streptococci were isolated from only three (1.0%) children, and they were all older than 6 years. A total of 143 viruses were isolated from 140 (47.6%) children. Adenovirus (18.7%) and enterovirus (16.3%) were the most common viral etiologies, followed by influenza virus (5.4%), parainfluenza virus (5.1%), herpes simplex virus Type 1 (2.7%), and respiratory syncytial virus (0.3%). Group A streptococcus only contributed to a minimal portion of acute exudative tonsillitis.
  
  
  CONCLUSIONS
  Routine or immediate antibiotic therapy for acute exudative tonsillitis in children is not necessary.
authors.affiliation: Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Tsung-Hsueh
authors.initials: TH
authors.lastname: Hsieh
authors.forename: Po-Yen
authors.initials: PY
authors.lastname: Chen
authors.forename: Fang-Liang
authors.initials: FL
authors.lastname: Huang
authors.forename: Jiann-Der
authors.initials: JD
authors.lastname: Wang
authors.forename: Li-Ching
authors.initials: LC
authors.lastname: Wang
authors.forename: Heng-Kuei
authors.initials: HK
authors.lastname: Lin
authors.forename: Hsiao-Chuan
authors.initials: HC
authors.lastname: Lin
authors.forename: Hsin-Yang
authors.initials: HY
authors.lastname: Hsieh
authors.forename: Meng-Kung
authors.initials: MK
authors.lastname: Yu
authors.forename: Chih-Feng
authors.initials: CF
authors.lastname: Chang
authors.forename: Tzu-Yau
authors.initials: TY
authors.lastname: Chuang
authors.forename: Chin-Yun
authors.initials: CY
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D004363:Drug Utilization / Q000592:standards*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010614:Pharynx / Q000382:microbiology / Q000821:virology; D015995:Prevalence; D011446:Prospective Studies; D013624:Taiwan / Q000453:epidemiology; D014069:Tonsillitis / Q000188:drug therapy* / Q000209:etiology*; D014777:Virus Diseases / Q000453:epidemiology* / Q000821:virology
chemical_list: D000900:Anti-Bacterial Agents