The Efficacy of Cefaclor vs Amoxicillin on Recovery After Tonsillectomy in Children

Abstract

Tonsillectomy and adenoidectomy continues to be one of the most commonly performed operations in the pediatric age group. The morbidity from tonsillectomy can be severe and includes throat and ear pain, fever, lethargy, and poor oral intake. A previous study at the Children's Hospital of Philadelphia (Pa) demonstrated the efficacy of amoxicillin therapy in minimizing some of these postoperative symptoms. However, some children continue to have a prolonged recovery even while receiving this antibiotic regimen. Because of these children and the high incidence of Staphylococcus found in tonsillar core tissue, a randomized, prospective study was undertaken at the Children's Hospital of Philadelphia to evaluate the efficacy of cefaclor vs amoxicillin in patients recovering from tonsillectomy. The patients received either ampicillin or cefazolin intravenously at the time of surgery and for 12 to 24 hours postoperatively. When oral intake was adequate, they received either amoxicillin or cefaclor orally for 7 additional postoperative days. Intraoperative cultures of the oropharynx and tonsillar tissue were obtained, as well as cultures of the tonsillar fossa 7 to 14 days postoperatively. The patients were evaluated for severity and duration of postoperative symptoms as well as complications. The results of this study showed no difference between the two groups of patients. We conclude that there is no justification for routine use of cefaclor over amoxicillin in the posttonsillectomy patient.

The use of perioperative antibiotics in tonsillectomy: Does it decrease morbidity?

“…Although these studies may have been useful in providing additional background information, they would not have been specifically useful for both, the qualitative and quantitative portions of this meta-analysis. On further review of the remaining 18 articles, 7 were withdrawn due to a lack of data regarding the primary clinical outcome of interest [9][10][11][12][13][14][15], and 5 were withdrawn due to the absence of a control 856 S. Iyer et al [16][17][18][19][20]. The seven remaining studies with usable information on post-operative outcomes of interest were included in the qualitative portion of this meta-analysis [21][22][23][24][25][26][27].…”

Avaliação da antibioticoterapia na morbidade pós-adenotonsilectomia: estudo prospectivo randomizado

“…Adenotonsillectomy still remains as one of the most frequent surgical procedures done in the pediatric population 2 . Morbidity in the post-op is mostly due to pain, fever, vomiting, bleeding, and fatigue, to name a few 5 .…”

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Antibióticos em tonsilectomias: terapêutico ou profilático? Necessário ou abusivo?

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