Telian S A, Handler S D, Fleisher G R, Baranak C C, Wetmore R F, Potsic W P
Arch Otolaryngol Head Neck Surg. 1986 Jun;112(6):610-5. doi: 10.1001/archotol.1986.03780060022002.
Tonsillectomy continues to be a commonly performed operation in the pediatric age group. The postoperative period is often protracted and characterized by throat and ear pain, intermittent fever, foul odor from the oral cavity, and poor oral intake. Consequently, antibiotics are frequently prescribed in an effort to minimize these symptoms and/or avoid complications such as dehydration or secondary infection of the operative site. However, to our knowledge, no study to date has been performed to demonstrate the efficacy of antibiotic therapy in this setting. At the Children's Hospital of Philadelphia, a prospective, randomized, double-blind study was undertaken in which ampicillin (or placebo) was administered intravenously at the time of surgery and for 12 to 24 hours postoperatively. The children then continued to receive oral amoxicillin therapy (or placebo) for an additional seven days. The patients were then evaluated for the incidence and severity of postoperative symptoms and complications. Intraoperative cultures of the oropharynx and tonsillar tissue, as well as cultures of the tonsillar fossa, were obtained following completion of one week of therapy. Our results indicate that ampicillin sodium/amoxicillin trihydrate therapy is well tolerated and safe in the nonallergic child and is effective in minimizing fever and other troublesome postoperative symptoms, such as pain, lassitude, mouth odor, and poor oral intake after tonsillectomy.
扁桃体切除术在儿童年龄组中仍然是一种常见的手术。术后恢复期往往较长，其特征为咽喉和耳部疼痛、间歇性发热、口腔异味以及口腔摄入量少。因此，经常开具抗生素以尽量减轻这些症状和/或避免并发症，如脱水或手术部位的继发感染。然而，据我们所知，迄今为止尚未进行任何研究来证明抗生素治疗在这种情况下的疗效。在费城儿童医院，进行了一项前瞻性、随机、双盲研究，在手术时及术后12至24小时静脉注射氨苄西林（或安慰剂）。然后，儿童继续接受口服阿莫西林治疗（或安慰剂）另外七天。然后对患者的术后症状和并发症的发生率及严重程度进行评估。在治疗一周结束后，获取口咽部和扁桃体组织的术中培养物以及扁桃体窝的培养物。我们的结果表明，氨苄西林钠/三水合阿莫西林治疗在非过敏儿童中耐受性良好且安全，并且在减轻发热和其他令人烦恼的术后症状方面有效，如扁桃体切除术后的疼痛、倦怠、口臭和口腔摄入量少。
