Reply to Baugh

We thank Dr Baugh for his letter related to the recent Infectious Diseases Society of America (IDSA) clinical practice guidelines for diagnosis and management of group A streptococcal pharyngitis [1, 2]. He indicates that the recent clinical practice guideline for tonsillectomy in children that he coauthored was incorrectly referenced and that none of the references cited includes adults. The IDSA guideline referenced the most pertinent studies available but found a marked scarcity of information specifically related to tonsillectomy in adults, and specifically a paucity of randomized clinical trials. We believe that our conclusions in fact are not “ambiguous, potentially misleading statements” as Dr Baugh suggests. That almost 100 000 children undergo tonsillectomy annually in the United States does not alter the fact that, as we state, tonsillectomy benefits only a relatively small group of patients with recurrent pharyngitis and that any benefit is usually relatively short-lived. Note