Prophylactic steroids and/or antibiotics to reduce post-tonsillectomy morbidity: a yet unanswered conundrum.

摘要

There are three symptoms that one would wish to avoid following tonsillectomy: postoperative nausea and vomiting, pain and secondary haemorrhage. The most recent 2010 Cochrane Review of Antibiotics to reduce post-tonsillectomy morbidity (pg 416) included one addition trial that was not in the earlier 2008 review. This enabled them to change their 'there is no evidence' recommendation to 'prophylactic antibiotics are not advocate routinely in patients under going tonsillectomy' as they do not reduce postoperative pain, need for analgesia and secondary haemorrhage. So what alternative prophylactic medication is available to us? The best source of quality evidence must be the Cochrane Database of Systematic Reviews whose ENT section has a current Impact Factor of 5.72. This is by far the highest for any ENT journal, the highest other non sub-specialist journal being Laryngoscope with an impact factor of 2.01.