Children who underwent adenoidectomy to manage recurrent upper-respiratory-tract infections (URTIs) continued to have a comparable infection rate to youngsters who went the watchful-waiting route.


Acute URTI is the most common diagnosis in children in primary care. Although adenoidectomy is usually done to reduce URTI incidence, evidence of the effectiveness of this approach is scarce, Anne Schilder, MD, and colleagues from the Netherlands, reported in BMJ. 


To learn more about the effectiveness of adenoidectomy for URTI, the investigators conducted a trial of 111 children in the Netherlands, aged 1 to 6 years, who had recurrent URTI and had been selected for adenoidectomy. The children were randomized to a strategy of immediate adenoidectomy (surgery within six weeks) or initial watchful waiting (40% of the watchful-waiting group members underwent surgery over the course of follow-up).


During median follow-up of 
24 months, 7.91 episodes of URTI per person-year occurred in the adenoidectomy group, compared with 7.84 in the watchful-
waiting group. Children who had undergone adenoidectomy had significantly more days with fever than did the other youths. URTI prevalence decreased over time in both groups.


In a separate project, probiotics were found to be better than placebo in reducing the number of persons experiencing acute URTI episodes. However, Bi Rong Dong, MD, and associates cautioned that their review of randomized controlled trials for The Cochrane Library had some limitations, and that the studies they evaluated had no data on older people. 


Schilder AGM et al. BMJ. 2011;DOI:10.1136/bmj.d5154.