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Covid-19 Primary Care Resources

Tonsillar examination

Long Covid children

The RCPCH continues to recommend that children’s throats should only be examined if essential

This information is sourced from the Royal College of Paediatrics and Child Health (RCPCH):

  • If a diagnosis of tonsillitis is suspected based on clinical history, the default remains not to examine the throat unless absolutely necessary
  • If the throat needs to be examined, the RCPCH now believe effective precautions can be taken by using droplet PPE (gown / gloves / surgical mask) with eye protection
  • If using the feverpain scoring system to decide if antibiotics are indicated (validated in children 3 years and older) a pragmatic approach should be adopted, and automatically starting with a score of 2 in lieu of an examination
  • Antibiotics should be considered in children with a total feverpain score of 4 or 5
  • Children with a score of 3 or less should receive safety netting advice alone
  • Although this is likely to result in a temporary increase in antibiotic prescribing in children this is preferable to healthcare staff being unnecessary exposed to Covid-19
  • Antibiotics rarely confer a benefit in children under 3 years with tonsillitis and should only be prescribed in exceptional circumstances or if a diagnosis of scarlet fever is strongly considered


Published: 21/04/2021