Can probiotic gargles reduce post-tonsillectomy morbidity in adult patients? A pilot, triple-blind, randomised, controlled trial and feasibility study

Abstract

Objective This study aimed to determine the efficacy of probiotic gargles compared with placebo gargles on reducing post-tonsillectomy morbidity in adults. Method This was a triple-blind, randomised, controlled trial and feasibility study. Thirty adults underwent elective tonsillectomy and were randomly assigned to receive either probiotic or placebo gargles for 14 days after surgery. Daily pain scores and requirement of analgesia were measured for 14 days post-operatively. Secondary outcomes assessed probiotic safety and tolerability and the feasibility of the trial. Results The probiotic group experienced less pain at rest on day 2. However, the amount of oxycodone (5 mg) tablets used was greater in the probiotic group compared with placebo. There were no statistically significant differences in the frequency of adverse effects between both groups. This trial was feasible. Conclusion This pilot study suggested that probiotic gargles do not reduce post-tonsillectomy pain or bleeding, highlighting the importance of pilot and feasibility studies in clinical research.

Post-tonsillectomy gargles, imaging in Ménière's disease, lateral cystic neck masses and digital medical records

“…Post-tonsillectomy gargles, imaging in Ménière's disease, lateral cystic neck masses and digital medical records Edward W Fisher and Jonathan Fishman, Editors Adult tonsillectomy is commonly performed, and the post-operative morbidity is sufficiently troublesome and variable that ENT surgeons have tried many treatments, including antibiotics, to try to minimise problems, and they have acknowledged a variety of factors that can influence wound healing. 1,2 This issue has a paper from Melbourne, Australia, 3 describing a pilot study investigating the effect of probiotic gargles on posttonsillectomy patient progress (pain, analgesic use and adverse events), as it would seem reasonable to link problems arising in the tonsillar fossa to the microbiology of the oropharynx (the 'microbiome'). Disappointingly, there seems to be no difference between a probiotic and a simple saline gargle, which supports the frequently stated 'truism' that it is the mechanical effect of the gargle which is likely to produce any resulting benefit.…”