The tonsils are a primary site where Group A strep takes up residence, and in some children, strep can hide in tonsillar crypts where antibiotics may not reach as effectively. The reasoning behind tonsillectomy is that removing the tonsils removes that recurring reservoir. The evidence is genuinely mixed. Some children with a clear pattern of strep-triggered episodes have improved after tonsillectomy. Others have not seen the relief they hoped for. Providers also genuinely disagree about who is a good candidate and when. An ENT evaluation — specifically looking at tonsil involvement and the child's overall pattern — is typically part of how this conversation unfolds for children who have not responded adequately to medical treatment. It is a surgical decision that requires individualized discussion with your medical team.