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Published on: November 6, 2019
Duration-related efficacy of postoperative antibiotics following pediatric tonsillectomy: a prospective, randomized,
Paul E Johnson1, Scott M Rickert, Jacqueline Jones
1Department of Otorhinolaryngology-Head and Neck Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, New York, New York, USA.
Insights
A 3-day course of antibiotics is as effective as a 7-day course for pediatric tonsillectomy recovery. This shorter antibiotic regimen reduces pain and speeds up diet and activity resumption post-surgery.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Pharmacology
Background:
- Post-tonsillectomy care often includes antibiotics.
- Optimal antibiotic duration for pediatric tonsillectomy remains under investigation.
- This study addresses the efficacy of shorter antibiotic courses.
Purpose of the Study:
- To compare the effectiveness of a 3-day versus a 7-day course of postoperative antibiotics.
- To evaluate the impact on pain, diet resumption, and activity levels after pediatric tonsillectomy.
- To determine if a reduced antibiotic duration is non-inferior to a standard duration.
Main Methods:
- Prospective, randomized, placebo-controlled trial at an academic medical center.
- 49 pediatric patients undergoing tonsillectomy were randomized to 3-day or 7-day amoxicillin courses.
- Outcomes included analgesic use, time to normal diet, and activity level resumption.
Main Results:
- No statistically significant differences were found between the 3-day and 7-day antibiotic groups.
- Postoperative pain levels were comparable between both treatment arms.
- Time to resumption of a normal diet and activity level showed no significant variation.
Conclusions:
- A 3-day course of postoperative antibiotics is as effective as a 7-day course for pediatric tonsillectomy.
- Shorter antibiotic duration does not compromise pain management or recovery milestones.
- This finding supports a potentially shorter antibiotic regimen in pediatric tonsillectomy patients.
Objective:
To determine whether a 3-day course of postoperative antibiotics is as effective as a 7-day course in reducing pain and reducing time to resumption of a normal diet and level of activity following pediatric tonsillectomy.
Design:
A prospective, randomized, placebo-controlled trial.
Setting:
Academic medical center.
Patients:
Forty-nine patients were enrolled in the study. Preoperative demographic information was obtained.
Interventions:
Tonsillectomy with or without adenoidectomy was performed by the senior author (J.J.) using electrocautery. Patients were randomized to receive either a 3- or 7-day course of amoxicillin.
Main Outcome Measures:
Parents were asked to record the following information: analgesic use for the first 7 postoperative days, postoperative days the child initiated his or her usual diet and level of activity, and medical treatment for oral hemorrhage or dehydration.
Results:
Of the 49 patients, 26 were randomized to receive 7 days of postoperative antibiotics (group A) and 23 to receive 3 days of antibiotics, followed by 4 days of placebo (group B). Results were obtained for 47 of the enrolled patients (96%). No statistically significant difference was noted between the 2 groups with regard to postoperative pain or time to resumption of a normal diet and level of activity.
Conclusion:
A 3-day course of antibiotics following pediatric tonsillectomy is as effective as a 7-day course with regard to postoperative analgesic use and resumption of normal diet and level of activity.
Trial Registration:
clinicaltrials.gov Identifier: NCT00662987.
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