gms | German Medical Science

Introduction: Tonsillectomy is one of the most commonly performed surgeries, which postoperative morbidity is often significant. Although numerous of studies consider the hypothesis that a reduction of the bacterial population of an open surgical wound could minimize the local inflammation, stimulate the healing process and hasten recovery, the justification for use of antibiotics in order to better outcome is still surrounded by controversy.

Aim: To determine whether perioperative antibiotics reduce postoperative morbidity of tonsillectomy in adults.

Material and methods: A retrospective review was conducted on medical records of 478 pateints (mean age 27.2), who underwent tonsillectomy from 2006 to 2010.

Results: Among the indications for surgery, chronic infections were in 384 (80.33%) patients, followed by focalosis in 83 (17.36%), suspected neoplasm in 6 (1.25%) and upper airway obstruction secondary to tonsillar hypertrophy in 5 (1.04%). Perioperative antibiotics were prescribed in 73 (15.27%) patients. Postoperative complications occurred in 85 (17.78%) cases, with hemorrhage in 34 (7.11%), followed by local infection in 25 (5.23%), prolonged analgetics use in 20 (4.18%), dehydration in 4 (0.84%) and hospitalization beyond 24 hours in 2 (0.42%). Patients who did not recived antibiotics perioperatively had an increased risk of postoperative complications than others who treated by antibiotics (19.74 vs 6.85%; p = 0.01).

Conclusion: Although we found better outcome in patients who recived antibiotics, we should not recommend the routine prescription of antibiotics to patients undergoing tonsillectomy, based on existing evidences in literature. Appropriate selection of patients who might benefit from antibiotics needs to be explored in future trials.