Summary: Inflammation of the tonsils, especially the PALATINE TONSILS but the ADENOIDS (pharyngeal tonsils) and lingual tonsils may also be involved. Tonsillitis usually is caused by bacterial infection. Tonsillitis may be acute, chronic, or recurrent.

Top Publications

  1. Aydin S, Aslan I, Yildiz I, Agachan B, Toptas B, Toprak S, et al. Vitamin D levels in children with recurrent tonsillitis. Int J Pediatr Otorhinolaryngol. 2011;75:364-7 pubmed publisher
    Although recurrent tonsillitis can be the consequence of defects in immune system, the exact etiology of recurrent tonsillitis is not clear...
  2. Dilek F, Sahin O, Tokyol C, Mazlum M, Aycicek A. Expression of cyclooxygenase-1 and 2 in chronic tonsillitis. Indian J Pathol Microbiol. 2010;53:451-4 pubmed publisher
    ..this study is to investigate the potential occurrence of COX-1 and COX-2 immunoreactivity in cases of chronic tonsillitis and to determine the sites of their expression...
  3. Fleckenstein J, Lill C, Lüdtke R, Gleditsch J, Rasp G, Irnich D. A single point acupuncture treatment at large intestine meridian: a randomized controlled trial in acute tonsillitis and pharyngitis. Clin J Pain. 2009;25:624-31 pubmed publisher
    ..This study was established to examine the immediate pain alleviating effect of a single point acupuncture treatment applied to the large intestine meridian of patients with sore throat...
  4. Skoulakis C, Tigiroglou E, Gkarelis K, Klapsa D, Damani A, Papadakis C, et al. Level of Streptococcus pyogenes in patients with recurrent tonsillitis and tonsillar hypertrophy. Scand J Infect Dis. 2008;40:899-903 pubmed publisher
    Recurrent tonsillitis is 1 of the common human infectious diseases worldwide, but, to date, its pathogenesis remains unclear...
  5. Winther B, Gross B, Hendley J, Early S. Location of bacterial biofilm in the mucus overlying the adenoid by light microscopy. Arch Otolaryngol Head Neck Surg. 2009;135:1239-45 pubmed publisher
    ..To determine the location of bacteria and biofilm in adenoid tissue and in mucus overlying the adenoid...
  6. Grasso D, Segat L, Zocconi E, Radillo O, Trevisiol C, Crovella S. MBL expression in patients with recurrent tonsillitis. Int J Pediatr Otorhinolaryngol. 2009;73:1550-3 pubmed publisher
    ..localization, MBL2 gene expression and genotypes distribution in patients characterized by recurrent tonsillitis, with the aim of verifying the innate immune response to the infection and inflammation occurring in the ..
  7. Iio K, Nagasawa Y, Iwatani H, Yamamoto R, Horii A, Okuzaki D, et al. Microarray analysis of tonsils in immunoglobulin A nephropathy patients. Biochem Biophys Res Commun. 2010;393:565-70 pubmed publisher
    ..expression in the tonsils (N=23) using microarray, compared with those with patients suffering from chronic tonsillitis (N=22)...
  8. Kawamata S, Yamada H, Sato Y, Sasagawa Y, Iwama Y, Matumoto M. [Evaluation of the safety and efficacy of cefditoren pivoxil fine granules for pediatric use in pediatric patients with laryngopharyngitis and tonsillitis caused by Streptococcus pyogenes]. Jpn J Antibiot. 2010;63:299-311 pubmed
    ..The response rate was 98.5% for laryngopharyngitis (457/464 patients) and 98.4% (250/254 patients) for tonsillitis. Examination of the response rates according to patient background showed that they were high, 95% or more, in ..
  9. Fagan M. [Is otitis and tonsillitis handled in the same way within normal working hours and out-of-hours?]. Tidsskr Nor Laegeforen. 2008;128:2340-2 pubmed
    ..The purpose of this study is to see whether physicians use diagnostic testing and prescribe antibiotics differently for acute otitis media (AOM) and tonsillitis when they work within normal working hours and out-of-hours.

More Information


  1. Visvanathan V, Nix P. National UK survey of antibiotics prescribed for acute tonsillitis and peritonsillar abscess. J Laryngol Otol. 2010;124:420-3 pubmed publisher
    To survey antibiotics prescribed for patients admitted with acute tonsillitis and peritonsillar abscess to UK ENT departments.
  2. Klug T, Henriksen J, Fuursted K, Ovesen T. Similar recovery rates of Fusobacterium necrophorum from recurrently infected and non-infected tonsils. Dan Med Bull. 2011;58:A4295 pubmed
    Recent studies implicate the presence of Fusobacterium necrophorum (FN) in recurrent tonsillitis (RT), acute tonsillitis and peritonsillar abscess...
  3. Di Pierro F, Adami T, Rapacioli G, Giardini N, Streitberger C. Clinical evaluation of the oral probiotic Streptococcus salivarius K12 in the prevention of recurrent pharyngitis and/or tonsillitis caused by Streptococcus pyogenes in adults. Expert Opin Biol Ther. 2013;13:339-43 pubmed publisher
    ..Because of its ability to colonize the oral cavity, we have tested the strain K12 for its efficacy in preventing streptococcal pharyngitis and/or tonsillitis in adults.
  4. Inci E, Karakullukcu B, Aygun G, Yasar H, Enver O, Yagiz C. Fine-needle aspiration as a diagnostic tool for recurrent tonsillitis. J Int Med Res. 2003;31:307-11 pubmed
    Acute tonsillitis is a common childhood disease, but repeated antibiotic treatment may fail, leading to tonsillectomy...
  5. Paradise J, Bluestone C, Colborn D, Bernard B, Rockette H, Kurs Lasky M. Tonsillectomy and adenotonsillectomy for recurrent throat infection in moderately affected children. Pediatrics. 2002;110:7-15 pubmed
    ..We conclude that, under ordinary circumstances, neither eligibility criteria such as those used for the present trials nor the criterion for surgery in current official guidelines are sufficiently stringent for use in clinical practice. ..
  6. Hultcrantz E, Linder A, Markstrom A. Long-term effects of intracapsular partial tonsillectomy (tonsillotomy) compared with full tonsillectomy. Int J Pediatr Otorhinolaryngol. 2005;69:463-9 pubmed
    ..Tonsillotomy with CO(2)-laser seems to be a reliable method for tonsil surgery with substantially less primary morbidity than conventional tonsillectomy and with the same positive long-term effects after six years. ..
  7. Gul M, Okur E, Ciragil P, Yildirim I, Aral M, Akif Kilic M. The comparison of tonsillar surface and core cultures in recurrent tonsillitis. Am J Otolaryngol. 2007;28:173-6 pubmed
    ..between tonsillar surface and deep tissue cultures in patients who underwent tonsillectomy for recurrent tonsillitis. Tonsillar surface and core tonsillar cultures were taken in all patients...
  8. Brook I. The role of bacterial interference in otitis, sinusitis and tonsillitis. Otolaryngol Head Neck Surg. 2005;133:139-46 pubmed
    ..These infections include pharyngo-tonsillitis, otitis media, and sinusitis...
  9. Rio A, Franchi Teixeira A, Nicola E. Relationship between the presence of tonsilloliths and halitosis in patients with chronic caseous tonsillitis. Br Dent J. 2008;204:E4 pubmed
    To study the volatile sulphur compounds (VSC) halitometry profile in a population with chronic caseous tonsillitis (CCT) and halitosis and to evaluate the relationship between the presence of a tonsillolith and abnormal halitometry in ..
  10. Pichichero M, Casey J. Systematic review of factors contributing to penicillin treatment failure in Streptococcus pyogenes pharyngitis. Otolaryngol Head Neck Surg. 2007;137:851-857 pubmed
    ..Further research is needed to better understand the mechanism(s) of penicillin treatment failure in GAS tonsillopharyngitis. ..
  11. van der Veen E, Sanders E, Videler W, van Staaij B, van Benthem P, Schilder A. Optimal site for throat culture: tonsillar surface versus posterior pharyngeal wall. Eur Arch Otorhinolaryngol. 2006;263:750-3 pubmed
    ..and the posterior pharyngeal wall of 50 children selected for adenotonsillectomy for symptoms of recurrent tonsillitis and/or adenotonsillar hypertrophy and of 50 children without upper respiratory disease...
  12. Brook I, Gober A. Increased recovery of Moraxella catarrhalis and Haemophilus influenzae in association with group A beta-haemolytic streptococci in healthy children and those with pharyngo-tonsillitis. J Med Microbiol. 2006;55:989-92 pubmed
    ..aureus and Streptococcus pneumoniae in association with GABHS in healthy children and those with acute pharyngo-tonsillitis (APT). Pharyngo-tonsillar cultures were obtained from 548 children with APT and 866 healthy children...
  13. Loganathan A, Arumainathan U, Raman R. Comparative study of bacteriology in recurrent tonsillitis among children and adults. Singapore Med J. 2006;47:271-5 pubmed
    Diagnosis and treatment of acute tonsillitis are one of the most common problems seen at an otorhinolaryngology clinic in both adult and paediatric populations...
  14. Mahakit P, Vicente J, Butt D, Angeli G, Bansal S, Zambrano D. Oral clindamycin 300 mg BID compared with oral amoxicillin/clavulanic acid 1 g BID in the outpatient treatment of acute recurrent pharyngotonsillitis caused by group a beta-hemolytic streptococci: an international, multicenter, randomized, investigat. Clin Ther. 2006;28:99-109 pubmed
    ..Patients who received clindamycin had significantly greater clinical cure rates at 12 days. Both regimens were well tolerated. ..
  15. Suvilehto J, Roivainen M, Seppanen M, Meri S, Hovi T, Carpen O, et al. Rhinovirus/enterovirus RNA in tonsillar tissue of children with tonsillar disease. J Clin Virol. 2006;35:292-7 pubmed
    ..One of the samples studied by all three methods, from a patient with recurrent tonsillitis, had no detectable HRV/HEV RNA...
  16. Ebenfelt A, Ericson L, Lundberg C. Acute pharyngotonsillitis is an infection restricted to the crypt and surface secretion. Acta Otolaryngol. 1998;118:264-71 pubmed
  17. Reichel O, Mayr D, Winterhoff J, de la Chaux R, Hagedorn H, Berghaus A. Tonsillotomy or tonsillectomy?--a prospective study comparing histological and immunological findings in recurrent tonsillitis and tonsillar hyperplasia. Eur Arch Otorhinolaryngol. 2007;264:277-84 pubmed
    We evaluated the differences in histological and immunological findings in children with recurrent tonsillitis and tonsillar hyperplasia and assessed the risk for relapsing tonsillar hyperplasia or recurrent tonsillitis after ..
  18. Kania R, Lamers G, Vonk M, Huy P, Hiemstra P, Bloemberg G, et al. Demonstration of bacterial cells and glycocalyx in biofilms on human tonsils. Arch Otolaryngol Head Neck Surg. 2007;133:115-21 pubmed
    ..Twenty-four tonsils were obtained from children with chronic or recurrent tonsillitis. Tonsils were prepared for analysis by scanning electronic microscopy and by confocal laser scanning microscopy...
  19. Podbielski A, Beckert S, Schattke R, Leithäuser F, Lestin F, Gossler B, et al. Epidemiology and virulence gene expression of intracellular group A streptococci in tonsils of recurrently infected adults. Int J Med Microbiol. 2003;293:179-90 pubmed
    ..An M-type-specific pattern of virulence gene expression and different gene expression levels in relation to the passage number were observed. ..
  20. Stenfors L, Bye H, Räisänen S. Noticeable differences in bacterial defence on tonsillar surfaces between bacteria-induced and virus-induced acute tonsillitis. Int J Pediatr Otorhinolaryngol. 2003;67:1075-82 pubmed
    ..lactoferrin, IgG and S-IgA) coat the tonsillar surface bacteria in healthy individuals, in patients with acute tonsillitis (AT) culture-positive for Streptococcus pyogenes, and in patients with infectious mononucleosis (IM) caused by ..
  21. Yokoyama M, Hashigucci K, Yamasaki Y. Effect of tonsillectomy in patients with pustulosis palmaris et plantaris. Acta Otolaryngol. 2004;124:1109-10 pubmed
  22. Shimizu T, Niizeki H, Takeuchi O, Yamasaki Y, Inamoto N, Kusunoki Y, et al. Induction of macrophage migration inhibitory factor precedes the onset of acute tonsillitis. Mediators Inflamm. 2004;13:293-5 pubmed
    ..To confirm these phenomena, two patients with acute tonsillitis had their changes in body temperature, C-reactive protein (CRP) and serum MIF levels examined during the course ..
  23. Brook I. The role of anaerobic bacteria in tonsillitis. Int J Pediatr Otorhinolaryngol. 2005;69:9-19 pubmed
    This review summarizes the information that supports the potential importance of anaerobic bacteria in tonsillitis. Some anaerobic bacteria possess interfering capability with Group A beta-hemolytic streptococci (GABHS) and other ..
  24. Brook I. Overcoming penicillin failures in the treatment of Group A streptococcal pharyngo-tonsillitis. Int J Pediatr Otorhinolaryngol. 2007;71:1501-8 pubmed
    The causes of penicillin failure in eradicating Group A beta-hemolytic streptococcal pharyngo-tonsillitis (GABHS PT) are described...
  25. Noda K, Kodama S, Suenaga S, Suzuki M. Tonsillar focal infectious disease involving IgA nephropathy, pustulosis, and ossification. Clin Exp Nephrol. 2007;11:97-101 pubmed
    ..Interestingly, all the symptoms of IgAN, PPP, and SCCH were alleviated 6 months after the tonsillectomy. Thus, tonsillectomy and steroid therapy may be effective and could be considered as treatment for these diseases...
  26. Galli J, Calo L, Ardito F, Imperiali M, Bassotti E, Fadda G, et al. Biofilm formation by Haemophilus influenzae isolated from adeno-tonsil tissue samples, and its role in recurrent adenotonsillitis. Acta Otorhinolaryngol Ital. 2007;27:134-8 pubmed
    ..tissue samples obtained from paediatric patients undergoing surgical treatment, for chronic and recurrent adeno-tonsillitis, not responding to repeated cycles of selective medical antibiotic and anti-inflammatory treatment and to assay ..
  27. Pavlik E, Lukes P, Potuznikova B, Astl J, Hrda P, Soucek A, et al. Helicobacter pylori isolated from patients with tonsillar cancer or tonsillitis chronica could be of different genotype compared to isolates from gastrointestinal tract. Folia Microbiol (Praha). 2007;52:91-4 pubmed
    Helicobacter pylori from patients with different diseases, including so-called autoimmune thyroiditis, chronic tonsillitis and tonsillar cancer, was isolated and cultured...
  28. Rudack C, Jorg S, Sachse F. Biologically active neutrophil chemokine pattern in tonsillitis. Clin Exp Immunol. 2004;135:511-8 pubmed
    ..the mechanisms of chronic and acute inflammation, the production of neutrophil chemokines in different types of tonsillitis - hyperplastic tonsillitis (HT), recurrent tonsillitis (RT) and peritonsillar abscesses (PA) - was investigated...
  29. van Staaij B, van den Akker E, De Haas Van Dorsser E, Fleer A, Hoes A, Schilder A. Does the tonsillar surface flora differ in children with and without tonsillar disease?. Acta Otolaryngol. 2003;123:873-8 pubmed
    ..004). H. influenzae was found in 32% of the children with recurrent tonsillitis, compared to 48% of the children with symptoms of tonsillar hypertrophy (p = 0.03)...
  30. Ohashi M, Yoshikawa T, Akimoto S, Fujita A, Hayakawa S, Takahashi M, et al. Severe acute tonsillitis caused by Rothia dentocariosa in a healthy child. Pediatr Infect Dis J. 2005;24:466-7 pubmed
    ..3 mg/dL). Rothia dentocariosa was recovered from the throat swab; many Gram-positive cocci were observed in the smear from the pseudomembrane covering the tonsil. ..
  31. Chole R, Faddis B. Anatomical evidence of microbial biofilms in tonsillar tissues: a possible mechanism to explain chronicity. Arch Otolaryngol Head Neck Surg. 2003;129:634-6 pubmed
    ..tissue and crypts of inflamed tonsils may explain the chronicity and recurrent characteristics of some forms of tonsillitis. To determine if microbial biofilms occur within clinically abnormal tonsils...
  32. Swidsinski A, Goktas O, Bessler C, Loening Baucke V, Hale L, Andree H, et al. Spatial organisation of microbiota in quiescent adenoiditis and tonsillitis. J Clin Pathol. 2007;60:253-60 pubmed
    ..The distribution of the bacteria within tonsils may be responsible for the failure of antibiotic treatment. ..
  33. Endo L, Ferreira D, Montenegro M, Pinto G, Altemani A, Bortoleto A, et al. Detection of Epstein-Barr virus in tonsillar tissue of children and the relationship with recurrent tonsillitis. Int J Pediatr Otorhinolaryngol. 2001;58:9-15 pubmed
    Recurrent tonsillitis has been the subject of much investigation...
  34. Nave H, Gebert A, Pabst R. Morphology and immunology of the human palatine tonsil. Anat Embryol (Berl). 2001;204:367-73 pubmed
    ..This is of increasing importance since it has been discovered in the last few years that the palatine tonsils are reservoir and replication sites of HIV. ..
  35. Jeong J, Lee D, Ryu R, Lee Y, Lee S, Kang J, et al. Bacteriologic comparison of tonsil core in recurrent tonsillitis and tonsillar hypertrophy. Laryngoscope. 2007;117:2146-51 pubmed
    ..We analyzed the differences between the bacterial pathogens in recurrent tonsillitis and tonsillar hypertrophy with regard to age, season, and antibiotic sensitivity...
  36. Jensen A, Hagelskjaer Kristensen L, Prag J. Detection of Fusobacterium necrophorum subsp. funduliforme in tonsillitis in young adults by real-time PCR. Clin Microbiol Infect. 2007;13:695-701 pubmed
    Throat swabs from 61 patients, aged 18-32 years, with non-streptococcal tonsillitis (NST) and 92 healthy controls were examined for the presence of Fusobacterium necrophorum DNA using a novel TaqMan-based real-time quantitative PCR assay ..
  37. Ericsson E, Graf J, Hultcrantz E. Pediatric tonsillotomy with radiofrequency technique: long-term follow-up. Laryngoscope. 2006;116:1851-7 pubmed
    ..yr) randomized to TT (n = 49) or TE (n = 43) groups because of obstructive problems with or without recurrent tonsillitis. One year after surgery, general health, degree of obstruction, history of infections, and behavior were ..
  38. Kasenõmm P, Mesila I, Piirsoo A, Kull M, Mikelsaar M, Mikelsaar R. Macroscopic oropharyngeal signs indicating impaired defensive function of palatine tonsils in adults suffering from recurrent tonsillitis. APMIS. 2004;112:248-56 pubmed
    The present study explored in adults suffering from recurrent tonsillitis the association between macroscopic oropharyngeal signs of recurrent inflammation, immunomorphology of palatine tonsils (counts of neutrophils by CD4 and ..
  39. Zhang P, Pang Y, Loh K, Wang D. Comparison of histology between recurrent tonsillitis and tonsillar hypertrophy. Clin Otolaryngol Allied Sci. 2003;28:235-9 pubmed
    To elucidate the aetiology of tonsillar hypertrophy and recurrent tonsillitis, it is important to determine whether a difference exists between these two conditions in microanatomical architecture...
  40. Somuk B, Sapmaz E, Soyalıç H, Yamanoğlu M, Mendil D, Arici A, et al. Evaluation of iron and zinc levels in recurrent tonsillitis and tonsillar hypertrophy. Am J Otolaryngol. 2016;37:116-9 pubmed publisher
    The aim of this study is to look into the roles of iron and zinc metals in etiopathogenesis of recurrent tonsillitis and tonsillar hypertrophy by evaluating the levels of iron and zinc elements in the palatine tonsillar tissue...
  41. Liess B, Mytyk C, Calhoun K, Whaley Connell A. Tonsillectomy for the treatment of tonsillitis-induced immunoglobulin A nephropathy. Am J Otolaryngol. 2010;31:485-8 pubmed publisher
    ..from red blood cell casts secondary to immunoglobulin A nephropathy (IgAN) is a rare, serious complication of tonsillitis that can cause acute renal failure, also referred to as acute kidney injury...
  42. Yildiz I, Unuvar E, Zeybek U, Toptas B, Cacina C, Toprak S, et al. The role of vitamin D in children with recurrent tonsillopharyngitis. Ital J Pediatr. 2012;38:25 pubmed
    The exact etiology of recurrent tonsillopharyngitis in children is not clear. Recurrent tonsillitis in children has multifactorial etiology like most of the diseases in childhood...
  43. Kordeluk S, Novack L, Puterman M, Kraus M, Joshua B. Relation between peritonsillar infection and acute tonsillitis: myth or reality?. Otolaryngol Head Neck Surg. 2011;145:940-5 pubmed publisher
    ..In addition, a database of patients diagnosed in the community with acute tonsillitis (AT) was reviewed for the same time period...
  44. Stelter K, Ihrler S, Siedek V, Patscheider M, Braun T, Ledderose G. 1-year follow-up after radiofrequency tonsillotomy and laser tonsillotomy in children: a prospective, double-blind, clinical study. Eur Arch Otorhinolaryngol. 2012;269:679-84 pubmed publisher more effective with respect to long-term outcome, recurrence of tonsillar hyperplasia and recurrence of tonsillitis. A prospective, randomised, double-blinded controlled clinical study was conducted at the Department of ..
  45. Kutluhan A, Salviz M, Yalciner G, Kandemir O, Yesil C. The role of the actinomyces in obstructive tonsillar hypertrophy and recurrent tonsillitis in pediatric population. Int J Pediatr Otorhinolaryngol. 2011;75:391-4 pubmed publisher
    To determine the prevalence of tonsillar Actinomyces in subjects with recurrent tonsillitis and those with obstructive tonsillar hypertrophy, and to determine the association between the presence of Actinomyces and tonsillar volume, and ..
  46. Lee E, Gabor M, Turner M, Ball M, Gabor L. Tonsillitis in a weaner pig associated with Geotrichum candidum. J Vet Diagn Invest. 2011;23:175-7 pubmed
    ..Histopathology indicated pyogranulomatous tonsillitis with intralesional fungal hyphae and arthrospores...
  47. Lukes P, Pacova H, Kucera T, Vesely D, Martinek J, Astl J. Expression of endothelial and inducible nitric oxide synthase and caspase-3 in tonsillar cancer, chronic tonsillitis and healthy tonsils. Folia Biol (Praha). 2008;54:141-5 pubmed
    ..The immunohistochemical reaction of eNOS, iNOS and caspase-3 in tonsillar cancer (N = 17), chronic tonsillitis (N = 11) and clinically healthy tonsils (N = 8) was detected...
  48. Schrock A, Send T, Heukamp L, Gerstner A, Bootz F, Jakob M. The role of histology and other risk factors for post-tonsillectomy haemorrhage. Eur Arch Otorhinolaryngol. 2009;266:1983-7 pubmed publisher
    ..Histopathological signs of cryptic tonsillitis and actinomyces infection displayed a statistically significant correlation with the risk of postoperative ..
  49. Reber A. [Airway management in sedated patients]. Anaesthesist. 2011;60:259-64 pubmed publisher
    ..In addition to different techniques of body positioning, simple airway maneuvers, such as chin lifting can maintain airway patency or open an obstructed upper airway. These maneuvers need an age-related evaluation and application. ..
  50. Tezer H, Sucakli I, Sayli T, Celikel E, Yakut I, Kara A, et al. Crimean-Congo hemorrhagic fever in children. J Clin Virol. 2010;48:184-6 pubmed publisher
    ..The clinical course of CCHF among children seems to be milder than in adults. Tonsillopharyngitis is a common symptom among children with CCHF. ..
  51. Little P, Stuart B, Hobbs F, Butler C, Hay A, Campbell J, et al. Predictors of suppurative complications for acute sore throat in primary care: prospective clinical cohort study. BMJ. 2013;347:f6867 pubmed publisher
    ..Clinicians will need to rely on strategies such as safety netting or delayed prescription in managing the uncertainty and low risk of complications. ..
  52. Bakhsh Z, Al Khatib T, Al Muhayawi S, Elassouli S, Elfiky I, Mourad S. Evaluating the therapeutic efficacy, tolerability, and safety of an aqueous extract of Costus speciosus rhizome in acute pharyngitis and acute tonsillitis. A pilot study. Saudi Med J. 2015;36:997-1000 pubmed publisher
    ..speciosus) rhizome in pediatric and adult patients suffering from acute pharyngitis and tonsillitis as an alternative to antibiotics use...
  53. Salatino S, Gray A. Integrative management of pediatric tonsillopharyngitis: An international survey. Complement Ther Clin Pract. 2016;22:29-32 pubmed publisher
    ..Natural remedies, and homeopathy in particular, are used in the management of URTIs. An integrative approach to these infections may help reduce excessive antibiotic prescription. ..