Mann E A, Blair E A, Levy A J, Chang A
Division of Otolaryngology-Head and Neck Surgery, Walter Reed Army Medical Center, Washington, DC 20307, USA.
Otolaryngol Head Neck Surg. 1999 Sep;121(3):277-82. doi: 10.1016/S0194-5998(99)70185-3.
Systemic antibiotics given during the first week after tonsillectomy appear to be effective in reducing postoperative morbidity. We assessed the effectiveness of perioperative topical antibiotic rinses in reducing posttonsillectomy morbidity.
A randomized, double-blinded, placebo-controlled pilot study of 36 patients undergoing tonsillectomy was used to evaluate the effects of a standard 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/clavulanate (Timentin).
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/Timentin (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.
Preliminary results indicate a reduction in oral bacterial counts and postoperative morbidity in adult patients receiving topical antibiotics compared with patients receiving placebo; further investigation is warranted.
扁桃体切除术后第一周给予全身抗生素似乎对降低术后发病率有效。我们评估了围手术期局部应用抗生素冲洗在降低扁桃体切除术后发病率方面的有效性。
一项针对36例接受扁桃体切除术患者的随机、双盲、安慰剂对照的前瞻性研究，用于评估围手术期静脉注射氨苄青霉素/口服阿莫西林的标准7天全身用药方案以及两种单日局部抗生素用药方案的效果：（1）克林霉素（氯洁霉素）和（2）阿莫西林/克拉维酸（奥格门汀）及替卡西林/克拉维酸（特美汀）。
与安慰剂组相比，两个局部治疗组术后第一天的需氧菌和厌氧菌口腔细菌计数均降低，奥格门汀/特美汀（需氧菌和厌氧菌计数）及氯洁霉素（需氧菌计数）达到统计学意义。与安慰剂组相比，氯洁霉素局部治疗组（分别为P = 0.014和P = 0.005）和奥格门汀/特美汀局部治疗组（分别为P = 0.026和P = 0.05）报告的术后疼痛和口臭明显减轻。
初步结果表明，与接受安慰剂的患者相比，接受局部抗生素治疗的成年患者口腔细菌计数和术后发病率降低；有必要进行进一步研究。
