Duration-Related Efficacy of Postoperative Antibiotics Following Pediatric Tonsillectomy

Johnson, Paul E.; Rickert, Scott; Jones, J. Albright

doi:10.1001/archoto.2009.146

Cited by 11 publications

(16 citation statements)

References 7 publications

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“…189 In addition, multiple studies have shown no significant change in pain, emergency room encounters, or hospitalization. 29,[190][191][192][193][194] Any real or theoretical benefit of antibiotics on recovery after tonsillectomy must be balanced against the known risks, harms, and adverse events of therapy. 195 Aside from the direct costs of acquiring the medications, adverse events include rash, allergy, and gastrointestinal upset or diarrhea.…”

Section: Supporting Textmentioning

confidence: 99%

Clinical Practice Guideline: Tonsillectomy in Children (Update)

Mitchell

Archer

Ishman

et al. 2019

Otolaryngol.--head neck surg.

390

470

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Objective. This update of a 2011 guideline developed by the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations on the pre-, intra-, and postoperative care and management of children 1 to 18 years of age under consideration for tonsillectomy. Tonsillectomy is defined as a surgical procedure performed with or without adenoidectomy that completely removes the tonsil, including its capsule, by dissecting the peritonsillar space between the tonsil capsule and the muscular wall. Tonsillectomy is one of the most common surgical procedures in the United States, with 289,000 ambulatory procedures performed annually in children \15 years of age based on the most recent published data. This guideline is intended for all clinicians in any setting who interact with children who may be candidates for tonsillectomy. KAS 14 (Postoperative codeine), and KAS 15a (Outcome assessment for bleeding). (6) Addition of an algorithm outlining KASs. (7) Enhanced emphasis on patient and/or caregiver education and shared decision making.

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Section: Supporting Textmentioning

confidence: 99%

Clinical Practice Guideline: Tonsillectomy in Children (Update)

Mitchell

Archer

Ishman

et al. 2019

Otolaryngol.--head neck surg.

390

470

View full text Add to dashboard Cite

show abstract

“…On the other hand, the local prescribing rationale suggests classifying tonsillectomy and adenoidectomy in subgroup A1, i.e., dirty/contaminated surgery and not in A3, i.e., clean surgery (29). Moreover, the use of different surgical techniques and varied access to the resources in a setting also affect the risk of surgical site infections and are a cause of prescribing antibiotics (30). Hence, the present diagnoses-specific study highlights our concern of applicability of available international guidelines, often based on surveillance data of highincome countries, to the other parts of the world especially to the LMICs.…”

Section: Discussionmentioning

confidence: 88%

Diagnose-Specific Antibiotic Prescribing Patterns at the Otorhinolaryngology Inpatient Departments of Two Private Healthcare Facilities in Central India: A Five Year Observational Study

Silfwerbrand

Verma

Sjökvist

et al. 2019

Preprint

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Background Antibiotics are overprescribed in low-and-middle-income countries where the infection rate is high. The global paucity of standard treatment guidelines and reliable prescription data is a barrier to rationalise antibiotic use and combat antibiotic resistance. Moreover, there is a lack of diagnose-specific prescription data from high infection risk departments such as the otorhinolaryngology (ENT). The purpose of the study was to present diagnose-specific antibiotic prescribing patterns at ENT inpatient departments of a teaching hospital and a non-teaching hospital from Indian private healthcare sector. Methods Data of all consecutive inpatients at the department (n=3527) were collected for five years (2008-2013). Analyses were conducted for inpatients aged >15 years (n=2909) using the World Health Organization’s methodologies. Patient records were divided into four diagnoses (indication) groups, i.e., surgical, non-surgical, chronic suppurative otitis media (CSOM) and others. Results Of 2909 inpatients, 51% had surgical diagnoses. An average of 83% inpatients in the clean surgery group, 78% in viral infection and 75% in non-infectious groups were prescribed antibiotics. CSOM was the most common diagnosis at both settings (883/2909 inpatients), where nearly 90% inpatients were prescribed antibiotics. Overall, third-generation cephalosporins and fluoroquinolones were most commonly prescribed. Conclusions This study highlights prescribing antibiotic to the unindicated diagnosis groups, i.e., clean surgeries, viral infections, and non-infectious diagnoses. Recommended single-prophylactic dose of antibiotic was not prescribed for the majority of clean-contaminated surgeries. Prolonged empirical prescribing and insignificant use of the microbiology laboratory was evident in both settings. A meticulous analysis of clean surgery group highlighted the universal applicability issue of available global guidelines.

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“…Johnson et al, who analyzed the process of postoperative healing in 49 tonsillectomy patients, comparing the effects of 3-and 7-day prophylactic administration of amoxicillin [13]. Irrespective of the regimen, the antibiotic prophylaxis proved equally effective in terms of the level of pain and the time before returning to a normal diet and physical ac- tivity.…”

Section: Discussionmentioning

confidence: 99%

“…Irrespective of the regimen, the antibiotic prophylaxis proved equally effective in terms of the level of pain and the time before returning to a normal diet and physical ac- tivity. In view of the reduced risk of adverse events, the lower probability of antibiotic resistance and decreased therapeutic costs, this finding justifies a shorter duration of therapy [13].…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, the bactericidal and bacteriostatic effects of perioperative antibiotic therapy should be reflected by decreased pain and improved healing. Moreover, the proponents of perioperative pharmacoprophylaxis emphasized another advantage -namely, the anti-inflammatory effect of antibiotics associated with documented in vitro inhibition of the release of pro-inflammatory cytokines: interleukin-1, -6 and -8, and tumor necrosis factor-alpha (TNF-α) from activated macrophages [2,[13][14][15].…”

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confidence: 99%

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