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Jacqueline Jones, MD; Steven D. Handler, MD; Michael Guttenplan, MD; William Potsic, MD; Ralph Wetmore, MD; Lawrence W. C. Tom, MD; Roger Marsh, PhD

Arch Otolaryngol Head Neck Surg. 1990;116(5):590-593.

Abstract
• Tonsillectomy and adenoidectomy continues to be one of the most commonly performed operations in the pediatric age group. The morbidity from tonsillectomy can be severe and includes throat and ear pain, fever, lethargy, and poor oral intake. A previous study at the Children's Hospital of Philadelphia (Pa) demonstrated the efficacy of amoxicillin therapy in minimizing some of these postoperative symptoms. However, some children continue to have a prolonged recovery even while receiving this antibiotic regimen. Because of these children and the high incidence of Staphylococcus found in tonsillar core tissue, a randomized, prospective study was undertaken at the Children's Hospital of Philadelphia to evaluate the efficacy of cefaclor vs amoxicillin in patients recovering from tonsillectomy. The patients received either ampicillin or cefazolin intravenously at the time of surgery and for 12 to 24 hours postoperatively. When oral intake was adequate, they received either amoxicillin or cefaclor orally for 7 additional postoperative days. Intraoperative cultures of the oropharynx and tonsillar tissue were obtained, as well as cultures of the tonsillar fossa 7 to 14 days postoperatively. The patients were evaluated for severity and duration of postoperative symptoms as well as complications. The results of this study showed no difference between the two groups of patients. We conclude that there is no justification for routine use of cefaclor over amoxicillin in the posttonsillectomy patient.

(Arch Otolaryngol Head Neck Surg. 1990;116:590-593)

Author Affiliations
From the Division of Otolaryngology, Children's Hospital of Philadelphia (Pa), and the Department of Otorhinoloaryngology and Human Communication, University of Pennsylvania School of Medicine, Philadelphia.

Footnotes
Accepted for publication January 3, 1990.

Presented as a poster at the annual meeting of the American Society of Pediatric Otolaryngology, San Diego, Calif, May 18, 1989.

Reprint requests to the Children's Hospital of Philadelphia, 34th and Civic Center Boulevard, Philadelphia, PA 19104 (Dr Handler).

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