Management of tonsillitis by the general practitioner.

Area of Science:

• General Practice
• Infectious Diseases
• Otolaryngology

Background:

• Recurrent acute tonsillitis poses a management challenge in primary care.
• Antibiotic resistance, particularly penicillinase-producing bacteria, may impact treatment efficacy.
• Surgical intervention is a common consideration for persistent tonsillitis.

Purpose of the Study:

• To assess primary care physicians' management strategies for recurrent acute tonsillitis.
• To identify common antibiotic choices and indications for surgical referral.
• To explore the influence of bacterial resistance on treatment decisions.

Main Methods:

• A questionnaire was administered to 107 general practitioners (GPs).
• Seventy-eight GPs (73.8%) completed the survey.
• Data collected included antibiotic preferences and surgical referral criteria.

Main Results:

• Penicillin was the preferred antibiotic (95%) for acute tonsillitis; ampicillin/amoxycillin were frequently recommended (45%).
• Erythromycin was the primary choice for penicillin-allergic patients (86%) and for refractory cases (35%).
• Recurrent tonsillitis was the most common reason for surgical referral (87%), with 71% of GPs citing multiple indications.

Conclusions:

• Current antibiotic prescribing for acute tonsillitis aligns with general recommendations.
• The high rate of surgical referral for recurrent tonsillitis warrants further investigation.
• The potential role of penicillinase-producing bacteria in recurrent tonsillitis requires consideration in treatment strategies.