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Antibiotic prophylaxis post-tonsillectomy: is it of benefit?
M P Colreavy1, D Nanan, M Benamer
1Department of Paediatric Otolaryngology, The Children's Hospital, Dublin, Ireland. mcolreavy@hotmail.com
International Journal of Pediatric Otorhinolaryngology
|December 22, 1999
Summary
Amoxicillin and clavulanic acid significantly reduced postoperative morbidity in children after tonsillectomy. This antibiotic treatment led to less pain and faster recovery compared to no treatment.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Infectious Diseases
Background:
- Antibiotic use post-tonsillectomy is debated.
- Tonsillar microflora changes implicate beta-lactamase producing bacteria like Haemophilus influenzae and Staphylococcus aureus.
- These bacteria can inactivate standard antibiotics.
Purpose of the Study:
- To evaluate the efficacy of amoxicillin and clavulanic acid in reducing postoperative morbidity after tonsillectomy.
- To compare outcomes in children receiving antibiotics versus no treatment.
Main Methods:
- A comparative study of two groups of children undergoing tonsillectomy.
- Group A (N=44) received amoxicillin and clavulanic acid for one week post-surgery.
- Group B (N=34) received no antibiotic treatment.
- Bacteriological profiles of tonsillar tissue and postoperative sites were analyzed.
Main Results:
- Key pathogens found in tonsil cores included Haemophilus influenzae (64%), Streptococcus viridans (55.9%), Staphylococcus aureus (37%), and anaerobes (25%).
- A high percentage of Staphylococcus aureus (86%) were beta-lactamase producers.
- Children receiving amoxicillin and clavulanic acid showed significantly reduced morbidity, evidenced by lower analgesia consumption, quicker resumption of normal diet (p=0.0072), and improved pain scores (p=0.0006).
Conclusions:
- Amoxicillin and clavulanic acid is effective in reducing postoperative morbidity in children following tonsillectomy.
- The use of this antibiotic regimen aids in faster recovery and pain management.