DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20210170

A study to assess the outcomes following tonsillectomy in patients who were administered only prophylactic pre-operative antibiotics vis-à-vis patients who were administered both pre and post-operative antibiotics

Shikha Shah, James Thomas, Tejal Sonar, Srinithya Kancherla, Aastha Bhatnagar

Abstract


Background: Tonsillectomy is one of the common operative surgery performed by an ENT surgeon. With aim to reduce the hospital stay and post-operative complications, the use of antibiotics has become every common.

Methods: 40 patients undergoing tonsillectomy were recruited into the study subsequent to obtaining informed consent. The patients were divided in to two groups, group A and group B. Both the groups were given tablet amoxicillin with clavulanic acid orally for 3 days prior to surgery and subsequently were administered injection amoxicillin and clavulanic acid intravenously 1 hour prior to surgery pre operatively. Only group A patients were given injection amoxicillin and clavulanic acid intravenously 12 hourly for 5 days in the post-operative period. The patients from both the groups were assessed on the following criteria: pain, slough in the tonsillar fossa, fever, clot formation and return to normal daily activities.  

Results: Both the groups were comparable with regard to demographics, post-operative infections, post-operative pain and time to return to normal daily activities. There was no cognisant difference for all the parameters assessed.

Conclusions: Administration of antibiotics in patients undergoing tonsillectomy can be restricted to pre-operative antibiotics only as giving antibiotics post-operatively does not affect the clinical outcome and also prevents indiscriminate use of antibiotics which can lead to mutant antibiotic resistant strains of bacteria which can also have an economic impact.

 


Keywords


Antibiotic prophylaxis, Clavulanic acid, Tonsillectomy

Full Text:

PDF

References


Parab SR, Khan MM. Is day care tonsillectomy a safe procedure? Indian J Otolaryngol Head Neck Surg. 2019;71(1):918-22.

Mishra P, Patni D, Kaushik M, Dehadaray A. Antibiotic following tonsillectomy: are we justified? Int Surg J. 2016;1(1):6-8.

Kardooni M, Mosavian SM, Lotfinia M, Eghbalnejad AM, Mofrad MS, Saki N, et al. Study of common bacterial agents and antibiotic susceptibility in patients with chronic and repeated tonsillitis. J Adv Pharm Educ Res. 2020;10(S2):91.

Heussien Z, Yousef N, Temark H, Ebnawaled AA. Isolation, identification and antibiogram study of pathogenic bacteria mediated children chronic tonsillitis at Qena University Hospital, Egypt. SVU-Int J Med Sci. 2020;3(2):1-8.

Colreavy MP, Nanan D, Benamer M, Donnelly M, Blaney AW, O’Dwyer TP, et al. Antibiotic prophylaxis post-tonsillectomy: is it of benefit? Int J Pediatr Otorhinolaryngol. 1999;50(1):15-22.

Erickson BK, Larson DR, St. Sauver JL, Meverden RA, Orvidas LJ. Changes in incidence and indications of tonsillectomy and adenotonsillectomy, 1970-2005. Otolaryngol Head Neck Surg. 2009;140(6):894-901.

Dhiwakar M, Eng CY, Selvaraj S, McKerrow WS. Antibiotics to improve recovery following tonsillectomy: a systematic review. Otolaryngol Head Neck Surg. 2006;134(3):357-64.

Lazim NM, Abdullah B, Salim R. The effect of Tualang honey in enhancing post tonsillectomy healing process. An open labelled prospective clinical trial. Int J Pediatr Otorhinolaryngol. 2013;77(4):457-61.

Windfuhr JP, Chen YS, Remmert S. Hemorrhage following tonsillectomy and adenoidectomy in 15,218 patients. Otolaryngol Head Neck Surg. 2006;132:281-6.

Grandis JR, Johnson JT, Vickers RM, Yu VL, Wagener MM, Wagner RL, et al. The efficacy of perioperative antibiotic therapy on recovery following tonsillectomy in adults: randomized double-blind placebo-controlled trial. Otolaryngol Head Neck Surg. 1992;106(2):137-42.

Mann EA, Blair EA, Levy AJ, Chang A. Effect of topical antibiotic therapy on recovery after tonsillectomy in adults. Otolaryngol Head Neck Surg. 1999;121(3):277-82.

Telian SA, Handler SD, Fleisher GR, Baranak CC, Wetmore RF, Potsic WP. The effect of antibiotic therapy on recovery after tonsillectomy in children: a controlled study. Arch Otolaryngol Head Neck Surg. 1986;112(6):610-5.

Cannon CR. The efficacy of a single dose antibiotic regimen in adults undergoing tonsillectomy. J Mississippi State Med Assoc. 1996;37(11):817-21.