Antibiotic prophylaxis post-tonsillectomy: is it of benefit?

The decision to prescribe antibiotics post-tonsillectomy still remains cont roversial. However, recent changing trends in the tonsillar tissue microflo ra have been widely reported, with Haemophilus influenzae, Staphylococcus a ureus and anaerobic organisms all being implicated. All of the above are be ta-lactamase producers and thus render lactamase prone antibiotics inactive . We compared two groups of children, one on Amoxycillin and clavulanic aci d (a lactamase stable antibiotic with anaerobic cover) for I week post tons illectomy - Group A (N=44), and another group on no treatment - Group B (N = 34). We compared tonsillar core, surface and postoperative tonsillar foss ae bacteriological profiles in the two groups. The tonsil core pathogens in cluded H. influenzae (64%) of which 9.5% were beta-lactamase producers, Str eptococcus viridans (55.9%), S. aureus (37%) of which 86% were beta-lactama se producers, and anaerobes which were found in 25% of samples. We found th at there was considerably less morbidity in those children receiving postop erative antibiotics compared to those who did not, as judged by the amount of analgesia consumed (p = 0.379), time to resumption of normal diet (p = 0 .0072) and pain analogue scores (p = 0.0006). We feel that treating childre n who have undergone tonsillectomy with amoxycillin and clavulanic acid sig nificantly reduces postoperative morbidity. (C) 1999 Elsevier Science Irela nd Ltd. All rights reserved.