An audit of prophylactic antibiotic treatment following tonsillectomy in children | The Journal of Laryngology & Otology | Cambridge Core

A prospective audit study was undertaken to assess the effect of two different management policies following tonsillectomy in children in this hospital, one of which requires a prophylactic five-day course of oral antibiotics and the other does not. A total of 95 children were entered into the trial: 54 received post-operative antibiotics and 41 did not. The post-operative recovery was assessed by completion of a parent questionnaire which included the following parameters: degree of patient distress, nausea and vomiting, otalgia, halitosis, pharyngeal bleeding, analgesic requirement, day of return to a regular diet and General Practitioner consultation. There was no significant reduction in any of the morbidity measures in patients treated with antibiotics. In fact, the analgesic requirement and the incidence of otalgia and irritability on Days 6 and 7 and secondary haemorrhage were significantly higher in the antibiotic-treated patients. Although the number of patients included in this study are small, the results suggest that post-operative antibiotics do not improve the outcome of uncomplicated tonsillectomy. Our previous practice of routinely administering antibiotics to post-tonsillectomy children has been discontinued as the consequence of this audit.

Benson-Mitchell, R., Maw, A. R. (1993) Assessment of sequelae at home following adenotonsillectomy. A basis for day-case management? Clinical Otolaryngology 18: 282–284.CrossRefGoogle ScholarPubMed

Handler, S. D., Miller, L., Richmond, K. H., Baranak, C. C. (1986) Post-tonsillectomy hemorrhage: incidence, prevention and management. Laryngoscope 1243–1247.CrossRefGoogle ScholarPubMed

Khan, M. H. Z., McCombie, A. W., Swift, A. C. (1994) Prophylactic antibiotic for tonsiliectomy? Pakistan Journal of Otolaryngology 10: 122–126.Google Scholar

Linden, B. E., Gross, C. W., Long, T. E., Lazar, R. H. (1990) Morbidity in pediatric tonsiliectomy. Laryngoscope 100: 120–124.CrossRefGoogle Scholar

Telian, S. A., Handler, S. D., Fleisher, G. R., Baranak, C. C., Wetmore, R. F., Potsic, W. P. (1986) The effect of antibiotic therapy on recovery after tonsiliectomy in children. Archives of Otolaryngology, Head and Neck Surgery 112: 610–615.CrossRefGoogle Scholar