Referral guideline – Recurrent tonsillitis

Introduction

Most sore throats are due to a viral infection.

Acute bacterial tonsillitis is more likely if there are tender and enlarged cervical lymph nodes, fever and absence of coryzal symptoms.

If acute bacterial tonsillitis is suspected, treat with Phenoxymethylpenicillin orally 15mg/kg/dose twice daily (Max 500mg/dose) for 10 days.

For delayed type hypersensitivity , use Roxithromycin PO’.

GP management

  • Long term prophylactic antibiotic therapy is not recommended
  • The decision to refer should be based on the frequency and severity of the infections

When to refer

  • 4 – 6 infections in 1 year
  • 4 infections/year for 2 consecutive years
  • 3 infections/year for 3 consecutive years
  • Significant impact on child’s education/school attendance or parental attendance at work
  • Refer to the emergency department is suspicious of quinsy (peritonsillar abscess) or airway compromise

Essential referral info

  • Presenting complaint and reason for referral
  • Detailed history of symptoms
  • Patient details (name, age and gender)
  • Medicare number
  • Parent/Carer’s name and contact details
  • Referring clinician details (name, contact details, provider number, date and length of referral)

From 1 May 2019 referral criteria will apply at CHQ. This condition has minimum demographic and essential clinical referral information that is required to be included prior to submission of the referral. Visit the CPC website for the required condition. If you are unable to provide the required “essential information” please state the reason when you submit the referral.

Helpful referral info

  • Other past medical and surgical history
  • Antenatal and perinatal history that may be relevant – prematurity, birth weight, birth trauma, or alcohol/drug use in pregnancy
  • Family history
  • Current medications and allergies
  • Immunisations
  • Examination findings – including any dysmorphic features, full ocular examination
  • Is the patient of Aboriginal or Torres Strait Islander descent?

Parent service

Otolaryngology Head and Neck Surgery

Contact details

Hospital Switchboard
(Ask for Otolaryngology (ENT) On-call Registrar)
t: 07 3068 1111