IDSA - Paradise Criteria for Tonsillectomy

Minimum frequency of sore throat episodes:

 • Seven or more episodes in the preceding year, OR

 • Five or more episodes in each of the preceding 2 y, OR 

 • Three or more episodes in each of the preceding 3 y

Clinical features

 • Temperature > 38.3C (>101F), OR

 • Cervical lymphadenopathy (tender lymph nodes or >2 cm), OR

 • Tonsillar exudate, OR

 • Positive culture for group A beta-hemolytic streptococcus

Treatment 

 • Antibiotics had been administered in conventional dosage for proved or suspected streptococcal episodes

Documentation

 • Each episode and its qualifying features had been substantiated by contemporaneous notation in a clinical record, OR

 •  If not fully documented, subsequent observance by the clinician of 2 episodes of throat infection with patterns of frequency and clinical features consistent with the initial history



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