Recurring strep throat: When is tonsillectomy useful?

My 7-year-old daughter has been diagnosed with strep throat four times in six months. Recently, after finishing a 10-day course of antibiotics, she again tested positive for strep. Should we consider having her tonsils removed?

- Jerrie / Texas

Answer

Usually, antibiotics kill strep bacteria. However, a child who repeatedly tests positive for strep throat may be a "strep carrier" or may indeed be getting repeated strep infections. In children who are strep carriers, the symptoms go away, but they still have strep bacteria remaining in their throats.

If a child has recurring strep throat — six or more positive strep cultures in one year — tonsillectomy may be considered. Children can still get strep throat after having their tonsils removed (tonsillectomy). But for some children with recurring strep throat, tonsillectomy reduces the frequency and severity of strep throat infections.

A 2006 Mayo Clinic study looked at the benefit of tonsillectomy in 290 children with recurring strep throat. Researchers reported that children who still had their tonsils were more than three times as likely to develop subsequent episodes of strep throat as were children who'd had their tonsils removed.

Tonsillectomy isn't recommended for every child with recurring strep throat. The decision to remove a child's tonsils must be weighed against many factors, including the frequency of strep throat infections, the risks of anesthesia and bleeding after the procedure, and missed school days to recover from the procedure.

Discuss with your pediatrician the potential benefit of tonsillectomy in your child's specific situation.

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