The Efficacy of Perioperative Antibiotic Therapy in Tonsillectomy Patients

Orłowski, Krzysztof; Lisowska, Grażyna; Misiołek, Hanna; Paluch, Zbigniew; Misiołek, Maciej

doi:10.17219/acem/59349

Cited by 9 publications

(21 citation statements)

References 41 publications

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“…189 In addition, multiple studies have shown no significant change in pain, emergency room encounters, or hospitalization. 29,[190][191][192][193][194] Any real or theoretical benefit of antibiotics on recovery after tonsillectomy must be balanced against the known risks, harms, and adverse events of therapy. 195 Aside from the direct costs of acquiring the medications, adverse events include rash, allergy, and gastrointestinal upset or diarrhea.…”

Section: Supporting Textmentioning

confidence: 99%

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Clinical Practice Guideline: Tonsillectomy in Children (Update)

Mitchell

Archer

Ishman

et al. 2019

Otolaryngol.--head neck surg.

408

470

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Objective. This update of a 2011 guideline developed by the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations on the pre-, intra-, and postoperative care and management of children 1 to 18 years of age under consideration for tonsillectomy. Tonsillectomy is defined as a surgical procedure performed with or without adenoidectomy that completely removes the tonsil, including its capsule, by dissecting the peritonsillar space between the tonsil capsule and the muscular wall. Tonsillectomy is one of the most common surgical procedures in the United States, with 289,000 ambulatory procedures performed annually in children \15 years of age based on the most recent published data. This guideline is intended for all clinicians in any setting who interact with children who may be candidates for tonsillectomy. KAS 14 (Postoperative codeine), and KAS 15a (Outcome assessment for bleeding). (6) Addition of an algorithm outlining KASs. (7) Enhanced emphasis on patient and/or caregiver education and shared decision making.

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Section: Supporting Textmentioning

confidence: 99%

“…189 In addition, multiple studies have shown no significant change in pain, emergency room encounters, or hospitalization. 29,190-194…”

Section: Guideline Key Action Statementsmentioning

confidence: 99%

Clinical Practice Guideline: Tonsillectomy in Children (Update)

Mitchell

Archer

Ishman

et al. 2019

Otolaryngol.--head neck surg.

408

470

View full text Add to dashboard Cite

show abstract

“…Following the injury, the tissue robustness and integrity should be constituted promptly in order to re-establish homeostatic mechanisms, prevent infection and minimize fluid loss [4]. Acute wound healing is composed of 4 phases known as hemostasis, inflammation, cellular proliferation and remodeling [4][5]. Following the surgery open tonsillar fossae is quickly covered with inflammatory mediators which initiate the proliferative phase 3-4 days after wound injury, leading to extracellular matrix (ECM) and granulation tissue formation.…”

Section: Discussionmentioning

confidence: 99%

“…Tonsillectomy is performed in a surgical field which is colonized by both saprophytic and pathogenic bacteria; hence it is associated with a risk of both local and systemic complications [5]. Local complications (1% of postoperative morbidity) are commonly related to surgical wound infections, whilst systemic complications which correspond to 0.2% of postoperative morbidity are associated with pneumonia, meningitis, sepsis etc.…”

Section: Discussionmentioning

confidence: 99%

“…Though it has been commonly performed for many years, complications are still encountered. The elective feature of the procedure and the surgical area in question, forces many scientists to search novel techniques, medications and devices to avoid the complications [3][4][5]. Besides giving the results of our 5 years' experience in tonsillectomy, we also aimed to investigate in detail, the post tonsillectomy infections (poorly mentioned in the literature so far) in our cohort and outline their relation with major factors, such as suturation of tonsillar pillars, local anesthesia infiltration, presence of Actinomyces in tonsil specimens and systemic co-morbidities.…”

Section: Introductionmentioning

confidence: 99%

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Review of 1078 tonsillectomy: Retrospective cohort study

Çoban¹,

Aydın²,

İnan³

et al. 2018

Journal of Surgery and Medicine

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Aim: Tonsillectomy is one of the most frequently performed otolaryngologic surgical procedures. We represented our 5 years of experience in tonsillectomy and intended to compare our results with the current literature. We aimed to discuss our tonsillectomy outcomes, mainly giving emphasis on our post tonsillectomy infections and their possible relation with tonsillar pillar suturation, local anesthesia infiltration, comorbidities and presence of Actinomyces colonies in tonsil specimens. Methods: This study was carried out retrospectively, in 1078 patients who underwent tonsillectomy operation in between December 2011 and December 2016. The demographic data of the patients, indications for tonsillectomy, suturation if applied, local anesthesia infiltration and its timing, histopathologic findings, co-morbid diseases, postoperative complications and re-hospitalizations were recorded. The association of suturation, infiltration of local anesthesia and it's timing (pre-incisional, post-dissectional), the histopathologic presentation of Actinomyces bacteria in tonsillar specimens and the presence of accompanying systemic disorders with post-tonsillectomy infections were statistically analyzed. Results: Postoperative infection was seen in 5 (0.5%) patients. Among the suturation group, only 1 (0.5%) patient had infection (p=1). In the infection group 4 (80%) patients had post dissectional local anesthesia infiltration (p=0.574). None of the patients treated with preincisional local anesthesia infiltration, had postoperative infection (p=0.574). In 3 (0.3%) patients, Actinomyces was determined. None of these cases had post-tonsillectomy infections. 142 (13.2%) patients had various co-morbidities associated. Among them, 1 (0.7%) patient had postoperative infection (p=0.507). Conclusion: According to our results, there is no statistically significant association between suturation of tonsillar pillars, local anesthesia infiltration, comorbidities and presence of Actinomyces and post tonsillectomy infections.

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The efficacy of perioperative antibiotic therapy in adenotonsillectomy children

Wang,

Zhao,

Wang

et al. 2023

Eur Arch Otorhinolaryngol

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Purpose: This prospective study was to evaluate the role of perioperative antibiotics use in children after adenotonsillectomy.Methods: A total of 246 children undergoing adenotonsillectomy admitted to our department from September 6 th 2021 to September 5 th 2022 were collected and randomly divided into observation group (128 cases) and control group (118 cases). The observation group received ampicillin sulbactam sodium intravenously 30min before and the day after surgery, while the control group was given saline instead. SPSS 27.0 was used for statistical analysis. Two independent samples mean T-test was used to evaluate the throat pain scores consecutive 3 days after the surgery, the time to resume to normal diet and the wound healing time between the two groups. Logistic regression analysis was used to evaluate the independent risk factors of the two groups. The generalized estimation model was used to evaluate the correlation between age and postoperative pain scores and the relationship between the different tonsillar bed grading and postoperative pain scores.Results: The pain scores were 5.83±1.879, 5.20±1.933 and 4.02±1.936 in the observation group and 6.83±1.892, 6.17±2.001 and 5.29±2.068 in the control group on day 1 to 3 after surgery, respectively. The difference between the two groups was statistically signi cant (P<0.01); The time of pain disappearance was (6.24±2.121) d in the observation group and (7.73±2.210) d in the control group, and the difference between the two groups was statistically signi cant (P<0.01). The wound repair time was (18.66±2.200) d in the observation group and (18.70±2.468) d in the control group. There was no signi cant difference between the two groups (P =0.874). Logistic regression analysis showed that fever was an independent risk factor for the two groups and was negatively correlated (B=-1.237, P<0.001, OR=0.290); Generalized estimation model showed that there was a positive correlation between age and pain scores (P<0.001) and with the increasing grading of tonsillar bed, the higher the pain scores was (P<0.001).Conclusions: Perioperative use of antibiotics in children with adenotonsillectomy can effectively reduce postoperative fever, throat pain symptoms and shorten the pain time. With the increasing of tonsillar bed grading, perioperative antibiotic therapy was more necessary. What is KnownAdenotonsillectomy is one of the most common surgeries in pediatric otorhinolaryngology for children with chronic/recurrent tonsillitis or obstructive sleep disorders.Postoperative hemorrhage and pain are the two major complaints. What is NewPerioperative use of antibiotics in children with adenotonsillectomy can effectively reduce postoperative fever, throat pain symptoms and shorten the pain time.With the increasing of tonsillar bed grading, perioperative antibiotic therapy was more necessary.

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The Efficacy of Perioperative Antibiotic Therapy in Tonsillectomy Patients

Cited by 9 publications

References 41 publications

Clinical Practice Guideline: Tonsillectomy in Children (Update)

Clinical Practice Guideline: Tonsillectomy in Children (Update)

Review of 1078 tonsillectomy: Retrospective cohort study

The efficacy of perioperative antibiotic therapy in adenotonsillectomy children

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