GuidelineEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2016
Clinical practice guideline: tonsillitis I. Diagnostics and nonsurgical management.
Guideline in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
49 citing papers in PubMed, 4 syntheses or guidelines pooled it, 161 citations in OpenAlex.
- Potential efficacy and safety of Xiyanping injection as adjuvant therapy in treatment of suppurative acute tonsillitis: a meta-analysis, trial sequential analysis, and certainty of evidence.Frontiers in pharmacology · 2024Pooled it
- A Five-Dimensional Network Meta-Analysis of Chinese Herbal Injections for Treating Acute Tonsillitis Combined With Western Medicine.Frontiers in pharmacology · 2022Pooled it
- Acute sore throat andBMJ open · 2021Pooled it
- Comparison of Centor and McIsaac scores in primary care: a meta-analysis over multiple thresholds.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Pooled it
- The Effect of Amoxicillin with Clavulanate on the Microbiota of Tonsillar Tissue in Disease: a Randomized Control Trial.Microbiology spectrum · 2022Trial
- A NEW TREATMENT MODALITY TO REDUCE ACUTE TONSILLITIS HEALING TIME.Journal of population therapeutics and clinical pharmacology = Journal de la therapeutique des populations et de la pharmacologie clinique · 2019Trial
- A population-based study of community antibiotic prescribing patterns in Alberta from 2010 to 2017: Implications for antibiotic stewardship.Canadian journal of public health = Revue canadienne de sante publique · 2026Article
- Medicinal plants as alternative and adjunct antimicrobial agents in ear, nose, and throat (ENT) Infections.Inflammopharmacology · 2026Review
- Article
- Comparative evaluation of subtotal and total tonsillectomy in the management of chronic tonsillopharyngitis in adults.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025Article
- Next-generation sequencing of the tonsillar microbiome in severe acute tonsillitis: comparison with healthy controls and culture-based findings.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Article
- Article
- Physicians' knowledge and adherence to Centor Criteria for preventing acute rheumatic fever in Jeddah, Saudi Arabia.Journal of medicine and life · 2025Article
- Optimization and preparation of in-situ mucoadhesive gel of azithromycin hydroxypropyl-β-cyclodextrin inclusion complex against upper respiratory tract infections.BMC pharmacology & toxicology · 2025Article
- Open, Randomised, Controlled Study to Evaluate the Role of a Dietary Supplement ContainingChildren (Basel, Switzerland) · 2025Article
- Global variation in antibiotic prescribing guidelines and the implications for decreasing AMR in the future.Frontiers in pharmacology · 2025Review
- Double trouble: Necrotizing tonsillitis in the setting ofRadiology case reports · 2024Article
- Article
- Importance of biomarkers in streptococcal acute tonsillitis & peritonsillar abscess.The Indian journal of medical research · 2024Article
- The Effects of a Dietary Supplement (PediaFlù) Plus Standard of Care in Children With Acute Tonsillopharyngitis/Rhinopharyngitis: Protocol for a Randomized Controlled Trial.JMIR research protocols · 2024Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
More than 120,000 patients are treated annually in Germany to resolve repeated episodes of acute tonsillitis. Therapy is aiming at symptom regression, avoidance of complications, reduction in the number of disease-related absences in school or at work, increased cost-effectiveness and improved quality of life. The purpose of this part of the guideline is to provide clinicians in any setting with a clinically focused multi-disciplinary guidance through different conservative treatment options in order to reduce inappropriate variation in clinical care, improve clinical outcome and reduce harm. Surgical management in terms of intracapsular as well as extracapsular tonsillectomy (i.e. tonsillotomy) is the subject of part II of this guideline. To estimate the probability of tonsillitis caused by β-hemolytic streptococci, a diagnostic scoring system according to Centor or McIsaac is suggested. If therapy is considered, a positive score of ≥3 should lead to pharyngeal swab or rapid test or culture in order to identify β-hemolytic streptococci. Routinely performed blood tests for acute tonsillitis are not indicated. After acute streptococcal tonsillitis, there is no need to repeat a pharyngeal swab or any other routine blood tests, urine examinations or cardiological diagnostics such as ECG. The determination of the antistreptolysin O-titer (ASLO titer) and other antistreptococcal antibody titers do not have any value in relation to acute tonsillitis with or without pharyngitis and should not be performed. First-line therapy of β-hemolytic streptococci consists of oral penicillin. Instead of phenoxymethylpenicillin-potassium (penicillin V potassium), also phenoxymethlpenicillin-benzathine with a clearly longer half-life can be used. Oral intake for 7 days of one of both the drugs is recommended. Alternative treatment with oral cephalosporins (e.g. cefadroxil, cefalexin) is indicated only in cases of penicillin failure, frequent recurrences, and whenever a more reliable eradication of β-hemolytic streptococci is desirable. In cases of allergy or incompatibility of penicillin, cephalosporins or macrolides (e.g. Erythromycin-estolate) are valuable alternatives.
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