Effect of pre-operative antibiotic treatment on the bacterial content of the tonsil

The impact of 7 days pre-tonsillectomy antibiotics on the aerobic bacterial content of the tonsil was studied in 70 consecutive patients. One group received no antibiotic, one group received pre-operative amoxycillin and the final group, pre-operative cefaclor. The qualitative bacteriology was similar in the three groups Haemophilus influenzae was the predominant isolate present in the centre ('core') of the resected tonsil. Similar numbers of beta-lactamase producers including H. influenzae and Straphylococcus aureus were found in all three groups. Quantitative bacteriology of the tonsil core demonstrated that there was a significant reduction in core tonsil pathogens associated with antibiotic therapy. The most statistically significant difference was between the untreated control group and the cefaclor treated group. We conclude that in patients with established recurrent acute tonsillitis, oral antibiotics penetrate the diseased tonsil and influence the predominant core aerobic microflora.