Parameter		AAO–HNS guidelines	Italian guidelines	Scottish guidelines
Audience		Multidisciplinary	Multidisciplinary	Multidisciplinary
Target population		Children and adolescents one to 18 years of age	Children and adults	Children four to 16 years of age and adults
Scope		Treatment of children who are candidates for tonsillectomy	Appropriateness and safety of tonsillectomy	Management of sore throat and indications for tonsillectomy
Methods		Based on a priori protocol, systematic literature review, American Academy of Pediatrics scale of evidence quality	Systematic literature review, Italian National Program Guidelines scale of evidence quality	Based on a priori protocol, systematic literature review, Scottish Intercollegiate Guidelines Network scale of evidence quality
Recommendations
	Recurrent infection	Tonsillectomy is an option for children with recurrent throat infection that meets the Paradise criteria (Table 1) for frequency, severity, treatment, and documentation of illness	Tonsillectomy is indicated in patients with at least one year of recurrent tonsillitis (five or more episodes per year) that is disabling and impairs normal activities, but only after an additional six months of watchful waiting to assess the pattern of symptoms using a clinical diary	Tonsillectomy should be considered for recurrent, disabling sore throat due to acute tonsillitis when the episodes are well documented, are adequately treated, and meet the Paradise criteria (Table 1) for frequency of illness
	Pain control	Recommendation to advocate for pain relief (e.g., provide information, prescribe) and educate caregivers about the importance of managing and reassessing pain	Recommendation for acetaminophen before and after surgery	Recommendation for adequate dose of acetaminophen for pain relief in children
	Antibiotic use	Recommendation against perioperative antibiotics	Recommendation for short-term perioperative antibiotics*	NA
	Steroid use	Recommendation for a single intraoperative dose of dexamethasone	Recommendation for a single intraoperative dose of dexamethasone	Recommendation for a single intraoperative dose of dexamethasone
	Sleep-disordered breathing	Recommendation to counsel caregivers about tonsillectomy as a means to improve health in children with sleep-disordered breathing and comorbid conditions	Recommendation for diagnostic testing in children with suspected sleep respiratory disorders	NA
	Polysomnography	Recommendation to counsel caregivers about tonsillectomy as a means to improve health in children with abnormal polysomnography	Recommendation for polysomnography when pulse oximetry results are not conclusive in agreement with Brouillette criteria	NA
	Surgical technique	NA	Recommendation for “cold” technique	NA
	Hemorrhage	Recommendation that the surgeon document primary and secondary hemorrhage after tonsillectomy at least annually	NA	NA
Adjunctive therapy		NA	NA	Recommendation against Echinacea purpurea for treatment of sore throat
				Recommendation for acupuncture in patients at risk of postoperative nausea and vomiting who cannot take antiemetic drugs