Microbial Composition, Antibiotic Sensitivity Patterns, and Contributing Factors Among Children With Tonsillitis in Hawassa Town, Sidama, Ethiopia

<b>Background:</b> Infections of the tonsils are very frequent among 5-14-year-old children due to poor immunity establishments and inflammation within the tonsils because of insufficient penetration of antibiotics into the tonsillar core. This study was aimed at determining the bacterial profile, antibacterial susceptibility pattern, and associated factors among children with tonsillitis from selected health facilities in Hawassa town, Sidama, Ethiopia. <b>Methods:</b> An institution-based cross-sectional study was conducted using interviewer-administered, pretested questionnaires, and throat swab samples were collected from children with tonsillitis visiting selected health facilities in Hawassa town. A systematic random sampling technique was used to select the study units. Antimicrobial susceptibility testing was carried out by using the disc diffusion method according to criteria set by the Clinical Laboratory and Standard Institute 2020. Logistic regression evaluated factors related to the prevalence of culture-confirmed bacterial tonsillitis. <b>Results:</b> The overall prevalence of bacterial tonsillitis among children (408) with tonsillitis among selected health facilities was 276/408 (67.6%) (95% CI: 63.0%, 72.0%). The dominant bacterial isolate was <i>Streptococcus pyogenes</i> (70) (25.4%), followed by <i>Streptococcus aureus</i> (59) (21.4%), <i>Staphylococcus epidermidis</i> (56) (20.3%), <i>Streptococcus pneumoniae</i> (35) (12.7%), and <i>Haemophilus influenzae</i> (27) (9.8%). <i>S. pyogenes</i> was resistant to cephalexin (45.7%), penicillin (44.3%), and ceftriaxone (42.9%). Higher odds of having bacterial tonsillitis were observed for children from low monthly income families (adjusted odds ratio (AOR) 2.31, 95% CI: 1.15-4.63), those with enlarged or tender glands (AOR 2.47, 95% CI: 1.57-3.88), and those with a history of recurrent tonsillitis (AOR 1.85, 95% CI: 1.18, 2.92). <b>Conclusions:</b> Bacterial tonsillitis was prevalent in the study area. The isolates showed resistance to common antibiotics such as penicillin, chloramphenicol, clindamycin, ceftriaxone, and cephalexin. Therefore, culture and susceptibility tests are vital for appropriately managing bacterial tonsillitis.