Effect of topical antibiotic therapy on recovery after tonsillectomy in adults

OBJECTIVE: Systemic antibiotics given during the first week after tonsillec tomy appear to be effective in reducing postoperative morbidity. We assesse d the effectiveness of perioperative topical antibiotic rinses in reducing posttonsillectomy morbidity. METHODS: A randomized, double-blinded, placebo-controlled pilot study of 36 patients undergoing tonsillectomy was used to evaluate the effects of a st andard 7-day systemic regimen of perioperative intravenous ampicillin/oral amoxicillin and 2 single-day topical antibiotic regimens: (1) clindamycin ( Cleocin) and (2) amoxicillin/clavulanate (Augmentin) and ticarcillin/clavul anate (Timentin). RESULTS: Mean aerobic and anaerobic oral bacterial counts were decreased in both topical treatment groups compared with the placebo group on the first postoperative day, achieving statistical significance with Augmentin/Timen tin (aerobic and anaerobic bacterial counts) and Cleocin (aerobic counts). Significantly less postoperative pain and mouth odor were reported for both Cleocin (P = 0.014 and P = 0.005, respectively) and Augmentin/Timentin (P = 0.026 and P = 0.05, respectively) topical treatment groups when compared with the placebo group. CONCLUSIONS: Preliminary results indicate a reduction in oral bacterial cou nts and postoperative morbidity in adult patients receiving topical antibio tics compared with patients receiving placebo; further investigation is war ranted.