{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T02:35:15Z","timestamp":1787884515806,"version":"build-2784847793"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,10,25]],"date-time":"2018-10-25T00:00:00Z","timestamp":1540425600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>(a) To report national trends for tonsillectomy, tonsillitis, peritonsillar abscess and deep neck space infection in secondary care. (b) To report national trends in sore throat consultations in primary care. (c) To report national trends in antibiotic prescribing in both primary and secondary care between 2011 and 2015.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective nationwide cohort study. Data requested from Information Statistics Department (<jats:styled-content style=\"fixed-case\">ISD<\/jats:styled-content>) Scotland for tonsillectomy, tonsillitis admissions, peritonsillar abscess admissions and deep neck space infection (<jats:styled-content style=\"fixed-case\">DNSI<\/jats:styled-content>) admissions in Scotland, between 1993\/94 and 2015\/16. Data for antibiotic prescriptions in general practice and hospital admissions between 2011 and 2015.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Scottish <jats:styled-content style=\"fixed-case\">ENT<\/jats:styled-content> departments and <jats:styled-content style=\"fixed-case\">GP<\/jats:styled-content> practices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Scottish patients who underwent tonsillectomy or were admitted to hospital with tonsillitis, peritonsillar abscess or deep neck space infection. Scottish patients that attended their <jats:styled-content style=\"fixed-case\">GP<\/jats:styled-content> with tonsillitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Tonsillectomy rates between 1993\/94 and 2015\/16 decreased by 48% (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Over the same time period, there has been a corresponding 136% increase in tonsillitis admission (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and a 167% increase in peritonsillar abscess admissions, (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Between 1996\/97 and 2015\/16, there was a 500% increase in deep neck space abscesses (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There has been a significant decrease in tonsillectomy rates over the past two decades. Over the same time period, there has been a significant increase in admissions to secondary care with tonsillitis, peritonsillar abscess and deep neck space infection. These changes have happened in the context of two separate national policies being introduced\u2014Scottish Intercollegiate Guideline Network (SIGN) guidelines for management of sore throat and the Scottish Reduction in Antibiotic Prescribing.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13233","type":"journal-article","created":{"date-parts":[[2018,9,27]],"date-time":"2018-09-27T14:40:15Z","timestamp":1538059215000},"page":"7-13","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["A 20\u2010year observational cohort of a 5 million patient population\u2014Tonsillectomy rates in the context of two national policy changes"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5564-1513","authenticated-orcid":false,"given":"Catriona M.","family":"Douglas","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Queen Elizabeth University Hospital Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ursula","family":"Altmyer","sequence":"additional","affiliation":[{"name":"Department of Microbiology Queen Elizabeth University Hospital Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Cottom","sequence":"additional","affiliation":[{"name":"Department of Microbiology Queen Elizabeth University Hospital Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Statistics Strathclyde University Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Penelope","family":"Redding","sequence":"additional","affiliation":[{"name":"Department of Microbiology Queen Elizabeth University Hospital Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise J.","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Queen Elizabeth University Hospital Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,10,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.309.6960.1011"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000000945"},{"key":"e_1_2_8_4_1","unstructured":"Increased Group A streptococcal activity in Scotland. Health Protection Scotland2015;49(11):109.http:\/\/www.hps.scot.nhs.uk\/documents\/ewr\/pdf2015\/1511.pdf. Accessed January 12 2017."},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38210.827917.7C"},{"key":"e_1_2_8_6_1","unstructured":"SIGN.Management of sore throat and indication of tonsillectomy. SIGN 117.2010;http:\/\/www.sign.ac.uk\/guidelines\/fulltext\/117\/. Accessed January 12 2017."},{"key":"e_1_2_8_7_1","unstructured":"Health Protection Scotland and Information Services Division.Scottish antimicrobial use and resistance in humans in 2015.2016."},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-013-2345-z"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1308\/003588414X13946184901966"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1308\/003588414X13946184900363"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2017.0193"},{"key":"e_1_2_8_12_1","unstructured":"ENT UK.Indications for tonsillectomy position paper. ENT UK London.2009."},{"issue":"3","key":"e_1_2_8_13_1","first-page":"179","article-title":"Epidemiology of tonsillectomy and\/or adenoidectomy in Italy","volume":"26","author":"Materia E","year":"2004","journal-title":"Pediatr Med Chir"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.01.044"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.3109\/02813432.2011.569140"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-14-151"},{"key":"e_1_2_8_17_1","unstructured":"ChoicesN.http:\/\/www.nhs.uk\/conditions\/Sore-throat\/Pages\/Introduction.aspx. Accessed January 12 2017."},{"key":"e_1_2_8_18_1","unstructured":"GP. WTWSaTFSa. YouGov.http:\/\/yougov.couk\/news\/2013\/08\/29\/waiting-times-would-third-stop-them-seeing-gp\/. Accessed January 12 2017."},{"key":"e_1_2_8_19_1","unstructured":"Health Do.1998.http:\/\/antibiotic-action.com\/wp-content\/uploads\/2011\/07\/Standing-Medical-Advisory-Committee-The-path-of-least-resistance-1998.pdf. Accessed January 12 2017."},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2710.2002.00405.x"},{"issue":"10","key":"e_1_2_8_21_1","doi-asserted-by":"crossref","first-page":"e003943","DOI":"10.1136\/bmjopen-2013-003943","article-title":"PRImary care Streptococcal Management (PRISM) study: identifying clinical variables associated with Lancefield group A beta\u2010haemolytic streptococci and Lancefield non\u2010Group A streptococcal throat infections from two cohorts of patients presenting with an acute sore throat","volume":"3","author":"Little P","year":"2013","journal-title":"BMJ Open"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01708619"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1128\/CVI.00347-15"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.000335"},{"key":"e_1_2_8_25_1","unstructured":"Scotland HP.Increased group A streptococcal activity in Scotland Volume 49 No. 2015\/11. 17 March2014."},{"key":"e_1_2_8_26_1","unstructured":"HPA.Infection reports. Pyogenic and non pyogenic streptococcal bacteraemia England Wales and Northern Ireland.2009.http:\/\/www.hpa.org.uk\/web\/HPAwebFile\/HPAweb_C\/1287144931510.2009. Accessed January 12 2017."},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.2807\/ese.14.05.19110-en"},{"key":"e_1_2_8_28_1","first-page":"CD001802","article-title":"Tonsillectomy or adenotonsillectomy versus non\u2010surgical treatment for chronic\/recurrent acute tonsillitis","volume":"11","author":"Burton MJ","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dym258"},{"issue":"1","key":"e_1_2_8_30_1","first-page":"63","article-title":"Influence of Tonsillectomy On Rheumatic Infection","volume":"55","author":"Ash R","year":"1938","journal-title":"Am J Dis Child"},{"key":"e_1_2_8_31_1","unstructured":"http:\/\/www.hsj.co.uk\/comment\/leader\/mckinsey-report-unthinkable-solutions-set-scene-for-nhs-cuts\/5015368.fullarticle. Accessed January 12 2017."},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12850"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/mlg.0b013e318031f0b0"}],"container-title":["Clinical Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcoa.13233","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.13233","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T22:27:25Z","timestamp":1694816845000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/coa.13233"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,25]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,1]]}},"alternative-id":["10.1111\/coa.13233"],"URL":"https:\/\/doi.org\/10.1111\/coa.13233","archive":["Portico"],"relation":{},"ISSN":["1749-4478","1749-4486"],"issn-type":[{"value":"1749-4478","type":"print"},{"value":"1749-4486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,25]]},"assertion":[{"value":"2017-08-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-09-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}