Efficacy of tonsillectomy in treatment of recurrent group A β-hemolytic streptococcal pharyngitis

OBJECTIVE: The objective of this study was to determine whether children with tonsillectomies experienced fewer recurrent group A β-hemolytic streptococcal (GABHS) infections after surgery compared with children who did not receive tonsillectomies. STUDY DESIGN/METHODS: The authors conducted a retrospective cohort study of 290 children 4 to <16 years who experienced three or more episodes of group A β-hemolytic streptococcal pharyngitis at least 1 month apart in 12 months. RESULTS: Children without tonsillectomy were 3.1 times (95% confidence interval, 1.9-4.9; P < .001) more likely to develop a subsequent group A β-hemolytic streptococcal pharyngitis infection during follow up than children who underwent tonsillectomy after adjusting for the number of group A β-hemolytic streptococcal pharyngitis infections per patient within the previous year and the presence of preexisting conditions. Among the children who developed a subsequent group A β-hemolytic streptococcal pharyngitis infection, the children without a tonsillectomy developed a group A β-hemolytic streptococcal pharyngeal infection sooner (median, 0.6 vs. 1.1 years). CONCLUSIONS: Tonsillectomy is associated with a decrease in the number of group A β-hemolytic streptococcal pharyngitis infections in children with a history of recurrent groups A β-hemolytic streptococcal pharyngitis infection. Tonsillectomy also increased the amount of time before development of further GABHS pharyngitis.