The antibiotic management of tonsillitis, acute otitis media, sinusitis and bronchitis is critically reviewed. Tonsillitis due to Group A streptococci must be treated with penicillin for 10 days in order to prevent complications. Antibiotics should not be used locally in pharyngitis or tonsillitis. Tonsillectomy does neither reduce the incidence of streptococcal tonsillitis nor of rheumatic complications. Antibiotic cover for tonsillectomy is not indicated except in patients with rheumatic heart disease or in those with prosthetic heart valves. The indications for the prophylactic use of antibiotics in ear, nose and throat surgery are discussed.