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Antibiotics to reduce post-tonsillectomy morbidity.

M Dhiwakar1, W A Clement, M Supriya

  • 1Raigmore Hospital, Department of Otolaryngology, Inverness, UK, IV2 3UJ. dhiwamahi@yahoo.com

The Cochrane Database of Systematic Reviews
|April 22, 2008
PubMed
Summary
This summary is machine-generated.

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Perioperative antibiotics do not significantly reduce pain or bleeding after tonsillectomy, but they may decrease fever. Caution is advised for routine antibiotic use in tonsillectomy patients.

Area of Science:

  • Otolaryngology
  • Surgical Oncology
  • Infectious Disease

Background:

  • Tonsillectomy is a common procedure with significant postoperative pain.
  • Bacterial infection is a suspected cause of post-tonsillectomy morbidity.
  • Perioperative antibiotics are sometimes used to reduce adverse outcomes.

Purpose of the Study:

  • To evaluate the effectiveness of perioperative antibiotics in reducing pain and other morbid outcomes following tonsillectomy.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs).
  • Searched Cochrane ENT Group Trials Register, CENTRAL, MEDLINE, and EMBASE up to March 2007.
  • Extracted data on pain, analgesia, hemorrhage, fever, and recovery.

Main Results:

Related Experiment Videos

  • Nine RCTs were included.
  • Antibiotics did not significantly reduce pain or the need for analgesia.
  • No significant reduction in secondary hemorrhage rates was observed.
  • Antibiotics were associated with a reduction in fever (RR 0.63, P=0.002).

Conclusions:

  • Limited evidence suggests antibiotics do not improve major outcomes like pain or hemorrhage after tonsillectomy.
  • Antibiotics may reduce fever post-tonsillectomy.
  • Methodological flaws in trials may bias results; routine antibiotic use is not recommended.
  • Further research is needed to identify patient subgroups who might benefit from selective antibiotic administration.