Antibiotic following tonsillectomy: are we justified?
Keywords:
Tonsillectomy, Secondary hemorrhage, AntibioticsAbstract
Background: Tonsillectomy remains one of the most commonly performed surgeries in ENT practice. Though rare, post-tonsillectomy hemorrhage is one of the most dreaded complications. Antibiotics are commonly used to reduce the risk of this complication. Not sufficient data is available to prove the use of antibiotics. Aim of current study was to study the role of antibiotics in prevention of post tonsillectomy secondary hemorrhage.
Methods:Randomized control trial was done. Pilot study on 92 patients, operated for tonsillectomy was randomly divided in two groups. All patients were operated by dissection method and both groups were matched in terms of types of anesthesia and post op analgesia. The first group was given antibiotics following tonsillectomy and the other group was not given antibiotics. These patients were followed up for 14 days.
Results:Only one patient in the group where antibiotic was given developed secondary hemorrhage and none of the patients in the non-antibiotic group developed any secondary hemorrhage.
Conclusion: This study does provide a level I evidence suggesting that routine use of antibiotic is not justified following tonsillectomy however a study with larger data is advocated.
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References
Cullen KA, Hall MJ, Golosinskiy A. Ambulatory surgery in the United States, 2006. In: Cullen KA, Hall MJ, Golosinskiy A, eds. National Health Statistics reports no. 11. Hyattsville, MD: National Center for Health Statistics; 2009: 1-28.
Rosenfeld RM, Green RP. Tonsillectomy and adenoidectomy: changing trends. Ann Otol Rhinol Laryngol. 1990;99:187-91
Ahsan F, Rashid H, Eng C, et al. Is secondary hemorrhage after tonsillectomy in adults an infective condition? Objective measures of infection in a prospective cohort. Otolaryngol. 2007;32:24-7.
Windfuhr JP, Chen YS, Remmert S. Hemorrhage following tonsillectomy and adenoidectomy in 15,218 patients. Otolaryngol Head Neck Surg. 2006;132:281-6.
Telian SA, Handler SD, Fleisher GR et al. The effect of antibiotic therapy on recovery after tonsillectomy in children: a controlled study. Arch Otolaryngol Head Neck Surg. 1986;112:610-5.
Dhiwakar M, Eng CY, Selvaraj S, McKerrow WS. Antibiotics to improve recovery following tonsillectomy: a systematic review. Otolaryngol Head Neck Surg. 2006 Mar;134(3):357-64.
Myssiorek D, Alvi A. Post-tonsillectomy hemorrhage: an assessment of risk factors. Int J Pediatr Otorhinolaryngol. 1996 Sep;37(1):35-43.
Iyer S, DeFoor W, Grocela J, Kamholz K, Varughese A, Kenna M. The use of perioperative antibiotics in tonsillectomy: does it decrease morbidity? Int J Pediatr Otorhinolaryngol. 2006 May;70(5):853-61.
Dhiwakar M, Clement WA, Supriya M, McKerrow W. Antibiotics to reduce post-tonsillectomy morbidity. Cochrane Database Syst Rev. 2010 Jul;(7):CD005607.
