BMJ  2007;334:1019 (19 May), doi:10.1136/bmj.39213.445856.BE

Letters

Recurrent pharyngo-tonsillitis

Time to stop doing tonsillectomies?

The first 150 words of the full text of this article appear below.

Alho et al conclude: "Tonsillectomy is an effective alternative for adults with a documented history of recurrent episodes of pharyngitis,"¹ but this assertion is unsupported by the evidence presented.

For those who had the early operation, the combined time with a sore throat including the operation was four days greater than for those whose operation was deferred.

People who were offered early tonsillectomy had fewer swabs taken than people given late tonsillectomy (5/36 v 20/34, P<0.0001). Yet, in the people who took swabs, there was little difference between positivity rates for group A streptococcal infection (1/5 samples (intervention) v 8/20 (control), P>>0.1). This comparison is still biased, albeit differently from the one reported in the paper.

The authors also say: "A substantial improvement over time in the rate of episodes of pharyngitis occurred in the control group during the follow-up, probably because of the natural course of the disease."¹ Isn't . . . [Full text of this article]

Croydon Primary Care Trust, Croydon, Surrey CR0 9XT

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Relevant Article

Tonsillectomy versus watchful waiting in recurrent streptococcal pharyngitis in adults: randomised controlled trial

Olli-Pekka Alho, Petri Koivunen, Tomi Penna, Heikki Teppo, Markku Koskela, and Jukka Luotonen
BMJ 2007 334: 939. [Abstract] [Full Text] [PDF]