Introduction: Overuse of antibiotics can lead to antimicrobial resistance and unnecessary costs. Although early studies reported improved outcomes following use of perioperative antibiotics for tonsillectomy, more recent studies have not been able to demonstrate a significant benefit on post tonsillectomy morbidity. Objective: To determine the need for postoperative antibiotics in children undergoing tonsillectomy under aseptic conditions at two tertiary care hospitals of Peshawar. Materials & Methods: Children aged 5-14 years admitted to the departments of Otorhinolaryngology-A unit of Hayatabad Medical Complex and Rehman Medical Institute, Peshawar from March 01, 2018 to September 30, 2018 for recurrent sore throat and recurrent quinsy were included in this quasi-experimental study based on prospective data collection and convenience sampling. Children with blood dyscrasias, upper and lower respiratory tract infections, and cardiopulmonary diseases were excluded. Routine preoperative investigations were done, and all were given postoperative analgesics. The patients were divided into two consecutive groups of 60 each; Group-A was given Co-amoxiclav 20mg/5mg/kg/day for 10 days and Group-B was not given any antibiotic. During their stay in the hospital and on follow up they were asked about pain via Visual Analogue Scale, and presence of fever and/or bleeding were documented. Results: Of 120 children, 50 (41.6%) were males and 70 (58.4%) were females, of ages 05-14 years; 01(1.6%) from Group-A and 01(1.6%) from Group-B presented with reactionary hemorrhage. However, 01(1.6%) from Group-A and 25(40%) from Group-B presented with secondary hemorrhage for which they were readmitted and put on injectable antibiotics. Similarly, 05(8.3%) from Group-A and 14(23.3%) from Group-B presented with pain for which pain killers were prescribed. Conclusion: Post tonsillectomy antibiotics may have a role in reducing the morbidities associated with the procedure in our setup. Keywords: Tonsillectomy; Postoperative Infections; Antibiotic Resistance; Hemorrhage.

Introduction: Otitis media, also known as middle ear infection, refers to any inflammation of the middle ear. It may be attributable to bacteria like Streptococcus pneumoniae and Hemophilus influenzae (most commonly involved), though viruses can also cause middle ear infection. It affects the pediatric group during the first three years of life, with 80% youngsters having had one otitis media episode at the minimum by age three years, 50% having had at least three episodes, while a smaller number experience their first episode after age three years. This phenomenon has also been linked to an increased presence of Streptococcus mutans which in turn raises the risk of acquiring dental caries. Objective: To determine whether an association exists between middle ear infection and the high occurrence of Streptococcus mutans that ultimately leads to dental caries in children and causes poor oral hygiene problems. Materials & Methods: A comprehensive and well-organized search of published articles was conducted in February 2022. The investigation was conducted using the Reporting Items for Systematic Reviews. Articles that fulfilled the predefined inclusion and exclusion criteria were appraised with respect to the key objectives of the review. Results: Based on the findings of the studies highlighted in this systematic review, not only was there a positive correlation between middle ear infection and dental caries, but some data were also supplied on the nature of the link between early childhood caries and middle ear infection. Conclusion: Increased Streptococcus mutans levels in early childhood together with other contributory risk factors such as middle ear infection could enhance the incidence of early childhood dental caries.