1 US Department of Health and Human Services. Agency for Health Care Policy and Research. Acute pain management: operative or medical procedures and trauma. Rockville (MD): The Agency; 1993. Clinical Practice Guideline No.1. AHCPR Publication No. 92-0023. p.107.

2 Blair RL, McKerrow WS, Carter NW, Fenton A. The Scottish tonsillectomy Audit. Audit Sub-Committee of the Scottish Otolaryngological Society. J Laryngol Otol 1996;110 Suppl 20:1-25. [section 1] [section 6]

3 Moloney JR, John DG, Jagger C. Age, sex, ethnic origin and tonsillectomy. J Laryngol Otol 1988; 102: 649-51.

4 Kljakovic M. Sore throat presentation and management in general practice. N Z Med J 1993; 106: 381-3. [section1] [section 2]

5 Data from R Milne, GPASS data evaluation project, University of Aberdeen.

6 Little PS, Williamson I. Are antibiotics appropriate for sore throats? Costs outweigh the benefits. BMJ 1994; 309: 1010-1.

7 Banks MH, Beresford SA, Morrell DC, Waller JJ, Watkins CJ. Factors influencing demand for primary medical care in women aged 20-44 years: a preliminary report. Int J Epidemiol 1975; 4: 189-95.

8 Shvartzman P. Are antibiotics appropriate for sore throats? Careful prescribing is beneficial. BMJ 1994; 309: 1011-2.

9 Little P, Williamson I. Sore throat management in general practice. Fam Pract 1996; 13: 317-21.

10 Touw-Otten FM, Johansen KS. Diagnosis, antibiotic treatment and outcome of acute tonsillitis: report of a WHO Regional Office for Europe study in 17 European countries. Fam Pract 1992; 9: 255-62.

11 Kolnaar BG, van den Bosch WJ, van den Hoogen HJ, van Weel C. The clustering of respiratory diseases in early childhood. Fam Med 1994; 26: 106-10.

12 Howie JG. Addressing the credibility gap in general practice research: better theory; more feeling; less strategy. Br J Gen Pract. 1996; 46: 479-81.

13 Howie JG, Porter AM, Forbes JF. Quality and the use of time in general practice: widening the discussion. BMJ 1989; 298: 1008-10.

14 Howie JG, Bigg AR. Family trends in psychotropic and antibiotic prescribing in general practice. BMJ 1980; 280: 836-8.

15 Little P, Gould C, Williamson I, Warner G, Gantley M, Kinmonth AL. Reattendance and complications in a randomised trial of prescribing strategies for sore throat: the medicalising effect of prescribing antibiotics. BMJ 1997; 315: 350-2.

16 Seppala H, Lahtonen R, Ziegler T, Meurman O, Hakkarainen K, Miettinen A, et al. Clinical scoring system in the evaluation of adult pharyngitis. Arch Otolaryngol Head Neck Surg 1993; 119: 288-91.

17 Meland E, Digranes, A, Skjærven R. Assessment of clinical features predicting streptococcal pharyngitis. Scand J Infect Dis 1993; 25: 177-83.

18 Stillerman M, Bernstein SH. Streptococcal pharyngitis. Evaluation of clinical syndromes in diagnosis. Am J Dis Child 1961; 101: 476-89.

19 Breese BB, Disney FA. The accuracy of diagnosis of beta streptococcal infections on clinical grounds. J Pediat 1954; 44: 670-3.

20 McIsaac W, Goel V, Slaughter PM, Parsons GW, Woolnough KV, Weir PT, et al. Reconsidering sore throats. Part 1: Problems with current clinical practice. Can Fam Physician 1997; 43: 485-93.

21 Caplan C. Case against the use of throat culture in the management of streptococcal pharyngitis. J Fam Pract 1979; 8: 485-90.

22 Feery BJ, Forsell P, Gulasekharam M. Streptococcal sore throat in general practice - a controlled study. Med J Aust 1976; 1: 989-91.

23 Brook I, Yocum P, Shah K. Surface vs core-tonsillar aerobic and anaerobic flora in recurrent tonsillitis. JAMA 1980; 244: 1696-8.

24 Uppal K, Bais AS. Tonsillar microflora - superficial surface vs deep. J Laryngol Otol 1989; 103: 175-7.

25 Schachtel BP, Fillingim JM, Beiter DJ, Lane AC, Schwartz LA. Subjective and objective features of sore throat. Arch Intern Med 1984; 144: 497-500.

26 Del Mar C. Managing sore throat: a literature review. I: Making the diagnosis. Med J Aust 1992; 156: 572-5.

27 Lewey S, White CB, Lieberman MM, Morales E. Evaluation of the throat culture as a follow-up for an initially negative enzyme immunosorbent assay rapid streptococcal antigen detection test. Pediatr Infect Dis J 1988; 7: 765-9.

28 Radetsky M, Wheeler RC, Roe MH, Todd JK. Comparative evaluation of kits for rapid diagnosis of group A streptococcal disease. Pediatr Infect Dis 1985; 4: 274-81.

29 Slifkin M, Gil GM. Evaluation of the Culturette brand ten-minute group A strep ID technique. J Clin Microbiol 1984; 20: 12-14.

30 White CB, Bass JW, Yamada SM. Rapid latex agglutination compared with the throat culture for the detection of group A streptococcal infection. Pediatr Infect Dis 1986; 5: 208-12.

31 Kellogg JA, Manzella JP. Detection of group A streptococci in the laboratory or physician's office. Culture vs antibody methods. JAMA 1986; 255: 2638-42.

32 Burke P, Bain J, Lowes A, Athersuch R. Rational decisions in managing sore throat: evaluation of a rapid test. BMJ 1988; 296: 1646-9.

33 Bertin L, Pons G, d'Athis P, Lasfargues G, Maudelonde C, Duhamel JF, et al. Randomised, double-blind, multicenter, controlled trial of ibuprofen versus acetaminophen (paracetamol) and placebo for treatment of symptoms of tonsillitis and pharyngitis in children. J Pediatr 1991; 119: 811-4.

34 Sauvage JP, Ditisheim A, Bessede JP, David N. Double-blind, placebo-controlled, multi-centre trial of the efficacy and tolerance of niflumic acid (`Nifluril') capsules in the treatment of tonsillitis in adults. Curr Med Res Opin 1990; 11: 631-7.

35 Manach Y, Ditisheim A. Double-blind, placebo-controlled multicentre trial of the efficacy and tolerance of morniflumate suppositories in the treatment of tonsillitis in children. J Int Med Res 1990; 18: 30-6.

36 Wethington JF. Double-blind study of benzydamine hydrochloride, a new treatment for sore throat. Clin Ther 1985; 7: 641-6.

37 Toner JG, Stewart TJ, Campbell JB, Hunter J. Tonsil flora in the very young tonsillectomy patient. Clin Otolaryngol 1986; 11: 171-4.

38 Little P, Williamson I, Warner G, Gould C, Gantley M, Kinnmonth AL. Open randomised trial of prescribing strategies in managing sore throat. BMJ 1997; 314: 722-7. [section 5.1] [section 5.5]

39 Holm SE. Reasons for failures in penicillin treatment of streptococcal tonsillitis and possible alternatives. Pediatr Infect Dis 1994; 13: 66-9.

40 Dykhuizen RS, Golder D, Reid TM, Gould IM. Phenoxymethyl penicillin versus co-amoxiclav in the treatment of acute streptococcal pharyngitis, and the role of beta-lactamase activity in saliva. J Antimicrob Chemother 1996; 37: 133-8.

41 Sirimanna KS, Madden GJ, Miles SM. The use of long-acting penicillin in the prophylaxis of recurrent tonsillitis. J Otolaryngol 1990; 19: 343-4.

42 Holm S, Henning C, Grahn E, Lomberg H, Staley H. Is penicillin the appropriate treatment for recurrent tonsillopharyngitis? Results from a comparative randomised blind study of cefuroxime axetil and phenoxymethylpenicillin in children. Scand J Infect Dis 1995; 27: 221-8

43 Foote PA, Brook I. Penicillin and clindamycin therapy in recurrent tonsillitis. Effect of microbial flora. Arch Otolaryngol Head Neck Surg 1989; 115: 856-9.

44 Brook I, Hirokawa R. Treatment of patients with a history of recurrent tonsillitis due to group A beta-hemolytic streptococci. A prospective randomized study comparing penicillin, erythromycin, and clindamycin. Clin Pediatr 1985; 24: 331-6.

45 Blumer JL, Goldfarb J. Meta-analysis in the evaluation of treatment for streptococcal pharyngitis: a review. Clin Ther 1994; 16: 604-20. [section 5.3] [section 5.6] [annex 4]

46 Shulman ST. Evaluation of penicillins, cephalosporins and macrolides for therapy in streptococcal pharyngitis. Pediatrics 1996; 97: 955-9. [section 5] [annex 4]

47 Howie JG, Foggo BA. Antibiotics, sore throats and rheumatic fever. J R Coll Gen Pract 1985; 35: 223-4.

48 Taylor JL, Howie JG. Antibiotics, sore throats and acute nephritis. J R Coll Gen Pract 1983; 33: 783-6.

49 Denny FW, Wannamaker LW, Brink WR, Rammelkamp CH, Custer EA. Prevention of rheumatic fever: Treatment of the preceding streptococcic infections. JAMA 1950; 143: 151-3.

50 Marlow RA, Torrez AJ, Haxby D. The treatment of nonstreptococcal pharyngitis with erythromycin: a preliminary study. Fam Med 1989; 21: 425-7. [section 5] [annex 4]

51 Del Mar C. Managing sore throat: a literature review. II. Do antibiotics confer benefit? Med J Aust 1992; 156: 644-9.

52 Merenstein JH, Rogers KD. Streptococcal pharyngitis. Early treatment and management by nurse practitioners. JAMA 1974; 227: 1278-82.

53 Randolph MF, Gerber MA, DeMeo KL, Wright L. Effect of antibiotic therapy on the clinical course of streptococcal pharyngitis. J Pediatr 1985; 106: 870-5.

54 Pichichero ME, Disney FA, Talpey WB, Green JL, Francis AB, Roghmann KJ, et al. Adverse and beneficial effects of immediate treatment of group A beta-hemolytic streptococcal pharyngitis with penicillin. Pediatr Infect Dis J 1987; 6: 635-43.

55 Middleton DB, D'Amico F, Merenstein JH. Standardised symptomatic treatment versus penicillin as initial therapy for streptococcal pharyngitis. J Pediatr 1988; 113: 1089-94.

56 Gerber MA. Antibiotic resistance: relationship to persistence of Group A streptococci in the upper respiratory tract. Pediatrics 1996; 97: 971-5.

57 Snellman LW, Stang HJ, Stang JM, Johnson DR, Kaplan El. Duration of positive throat cultures for group A streptococci after initiation of antibiotic therapy. Pediatrics 1993; 91: 1166-70.

58 Bisset AF, Russell D. Grommets, tonsillectomies and deprivation in Scotland. BMJ 1994; 308: 1129-32.

59 Clinical Outcomes Working Group. Clinical Outcome indicators. Edinburgh, Scottish Office, 1996.

60 Paradise JL, Bluestone CD, Bachman RZ, Colborn DK, Bernard BS, Taylor FH, et al. Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of parallel randomized and nonrandomized clinical trials. N Engl J Med 1984; 310: 674-83. [section 6.2] [section 6.3]

61 Laing MR, McKerrow WS. Adult tonsillectomy. Clin Otolaryngol 1991; 16: 21-4.

62 McKee WJ. A controlled study of the effects of tonsillectomy and adenoidectomy in children. J Br Soc Prev Med 1963; 17: 49-69.

63 Mawson SR, Adlington P, Evans M. A controlled study evaluation of adeno-tonsillectomy in children. J Laryngol Otol 1967; 81: 777-90.

64 Roydhouse N. A controlled study of adenotonsillectomy. Arch Otolaryngol 1970; 92: 611-6.

65 Camilleri AE, MacKenzie K, Gatehouse S. The effect of recurrent tonsillitis and tonsillectomy on growth in childhood. Clin Otolaryngol 1995; 20: 153-7.

66 Ahlqvist-Rastad J, Hultcrantz E, Melander H, Svanholm H. Body growth in relation to tonsillar enlargement and tonsillectomy. Int J Pediatr Otorhinolaryngol 1992; 24: 55-61.

67 Williams EF III, Woo P, Miller R, Kellman RM. The effects of adenotonsillectomy on growth in young children. Otolaryngol Head Neck Surg 1991; 104: 509-16.

68 Bass JW, Crast FW, Knowles CR, Onufer CN. Streptococcal pharyngitis in children. A comparison of four treatment schedules with intramuscular penicillin G benzathine. JAMA 1976; 235: 1112-6.

69 Gerber MA, Randolph MF, Chanatry J, Wright LL, De Meo K, Kaplan EL. Five vs ten days of penicillin V therapy for streptococcal pharyngitis. Am J Dis Child 1987; 141: 224-7.

70 Pichichero ME, Margolis PA. A comparison of cephalosporins and penicillins in the treatment of group A beta-hemolytic streptococcal pharyngitis: a meta-anyalsis supporting the concept of microbial copathogenicity. Pediatr Infect Dis J 1991; 10: 275-81.

71 Stillerman M, Aronovitz GH, Durnell MD, Rosenberg R. Comparison between cephalexin two-and four-time per day regimens in group A streptococcal pharyngitis. Clin Pediatr 1984; 23: 348-51.

72 Fyllingen G, Arnesen AR, Biermann C, Kaarby O, Romfo O, Ronnevig J, et al. Phenoxymethylpenicillin two or three times daily for tonsillitis with beta-haemolytic streptococci group A: a blinded, randomised and controlled clinical study. Scand J Infect Dis 1991; 23: 553-8.

73 Kaufhold A. Randomised evaluation of benzathine penicillin V twice daily versus potassium penicillin V three times daily in the treatment of group A streptococcal pharyngitis. Eur J Clin Microbiol Infect Dis 1995; 14: 92-8.

74 Howe RW, Millar MR, Coast J, Whitfield M, Peters TJ, Brookes S. A randomised controlled trial of antibiotics on symptom resolution in patients presenting to their general practitioner with a sore throat. Br J Gen Pract 1997; 47: 280-4.