[Is postoperative antibiotic treatment mandatory after abscess tonsillectomy]

Peritonsillar abscess (PTA) is a common and serious complication of acute exudative tonsillitis. We wanted to answer the following question: Are postoperative antibiotics mandatory after abscess tonsillectomy?

In an epidemiological observational study, 283 patients (98 females and 185 males, age range 2-72 years) were treated with abscess tonsillectomy for PTA. For a prospective randomized multicenter study, 105 patients were divided into two groups; one group was treated postoperatively with benzylpenicillin, and antibiotics were omitted in the control group. We evaluated postoperative pain scores, swallowing disorders, and well-being. Additionally, laboratory parameters such as C-reactive protein, leukocytes, and antistreptolysin titer were measured, and blood cultures were collected.

Male patients in the 2nd-4th decades of life were predominantly affected, mostly in the summer. For the patients in the two groups, we assessed no significant differences in either the subjective or the laboratory parameters. The blood cultures showed no evidence of bacteremia.

We conclude that immediately performed abscess tonsillectomy is an effective and safe treatment for PTA. No higher complication rate was found when additional antibiotic treatment was not used. Because of the small number of cases, the results can be regarded only as a tendency, not as a general recommendation.