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The Effect of Antibiotic Therapy on Recovery After Tonsillectomy in ChildrenA Controlled Study
Steven A. Telian, MD;
Steven D. Handler, MD;
Gary R. Fleisher, MD;
Christine C. Baranak, MA;
Ralph F. Wetmore, MD;
William P. Potsic, MD
Arch Otolaryngol Head Neck Surg. 1986;112(6):610-615.
Abstract
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• Tonsillectomy continues to be a commonly performed operation in the pediatric age group. The postoperative period is often protracted and characterized by throat and ear pain, intermittent fever, foul odor from the oral cavity, and poor oral intake. Consequently, antibotics are frequently prescribed in an effort to minimize these symptoms and/or avoid complications such as dehydration or secondary infection of the operative site. However, to our knowledge, no study to date has been performed to demonstrate the efficacy of antibiotic therapy in this setting. At the Children's Hospital of Philadelphia, a prospective, randomized, double-blind study was undertaken in which ampicillin (or placebo) was administered intravenously at the time of surgery and for 12 to 24 hours postoperatively. The children then continued to receive oral amoxicillin therapy (or placebo) for an additional seven days. The patients were then evaluated for the incidence and severity of postoperative symptoms and complications. Intraoperative cultures of the oropharynx and tonsillar tissue, as well as cultures of the tonsillar fossa, were obtained following completion of one week of therapy. Our results indicate that ampicillin sodium/amoxicillin trihydrate therapy is well tolerated and safe in the nonallergic child and is effective in minimizing fever and other troublesome postoperative symptoms, such as pain, lassitude, mouth odor, and poor oral intake after tonsillectomy.
(Arch Otolaryngol Head Neck Surg 1986;112:610-615)
Author Affiliations
From the Departments of Otolaryngology and Human Communication (Drs Telian, Handler, Wetmore, and Potsic, and Ms Baranak) and Infectious Diseases (Dr Fleisher), Children's Hospital of Philadelphia; and the Department of Otorhinolaryngology and Human Communication, University of Pennsylvania School of Medicine, Philadelphia (Drs Telian, Handler, Wetmore, and Potsic, and Ms Baranak).
Footnotes
Accepted for publication Nov 25, 1985.
Presented in part at the annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery, Las Vegas, Sept 16, 1984.
Reprint requests to Department of Otorhinolaryngology and Human Communication, Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104 (Dr Handler).
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