Lee W C, Duignan M C, Walsh R M, McRae-Moore J R
Queen Elizabeth Hospital, Edgbaston, Birmingham, UK.
J Laryngol Otol. 1996 Apr;110(4):357-9. doi: 10.1017/s0022215100133614.
A prospective audit study was undertaken to assess the effect of two different management policies following tonsillectomy in children in this hospital, one of which requires a prophylactic five-day course of oral antibiotics and the other doses not. A total of 95 children were entered into the trial: 54 received post-operative antibiotics and 41 did not. The post-operative recovery was assessed by completion of a parent questionnaire which included the following parameters: degree of patient distress, nausea and vomiting, otalgia, halitosis, pharyngeal bleeding, analgesic requirement, day of return to a regular diet and General Practitioner consultation. There was no significant reduction in any of the morbidity measures in patients treated with antibiotics. I fact, the analgesic requirement and the incidence of otalgia and irritability on Days 6 and 7 and secondary haemorrhage were significantly higher in the antibiotic-treated patients. Although the number of patients included in this study are small, the result suggest that post-operative antibiotics do not improve the outcome of uncomplicated tonsillectomy. Our previous practice of routinely administering antibiotics to post-tonsillectomy children has been discontinued as the consequence of this audit.
开展了一项前瞻性审计研究，以评估本院两种不同管理策略对儿童扁桃体切除术后的影响，其中一种策略要求进行为期五天的预防性口服抗生素治疗，另一种则不使用抗生素。共有95名儿童参与了该试验：54名接受了术后抗生素治疗，41名未接受。通过完成一份家长问卷来评估术后恢复情况，问卷包括以下参数：患者痛苦程度、恶心和呕吐、耳痛、口臭、咽部出血、镇痛需求、恢复正常饮食的天数以及全科医生会诊情况。接受抗生素治疗的患者在任何一项发病率指标上均未出现显著降低。事实上，接受抗生素治疗的患者在镇痛需求、第6天和第7天的耳痛和易怒发生率以及继发性出血方面显著更高。尽管本研究纳入的患者数量较少，但结果表明术后抗生素并不能改善无并发症扁桃体切除术的预后。作为此次审计的结果，我们此前对扁桃体切除术后儿童常规使用抗生素的做法已停止。
