Effect of topical antibiotic therapy on recovery after tonsillectomy in adults.
OBJECTIVE
Systemic antibiotics given during the first week after tonsillectomy appear to be effective in reducing postoperative morbidity. We assessed the effectiveness of perioperative topical antibiotic rinses in reducing posttonsillectomy morbidity.


METHODS
A randomized, double-blinded, placebo-controlled pilot study of 36 patients undergoing tonsillectomy was used to evaluate the effects of a standard 7-day systemic regimen of perioperative intravenous ampicillin/oral amoxicillin and 2 single-day topical antibiotic regimens: (1) clindamycin (Cleocin) and (2) amoxicillin/clavulanate (Augmentin) and ticarcillin/clavulanate (Timentin).


RESULTS
Mean aerobic and anaerobic oral bacterial counts were decreased in both topical treatment groups compared with the placebo group on the first postoperative day, achieving statistical significance with Augmentin/Timentin (aerobic and anaerobic bacterial counts) and Cleocin (aerobic counts). Significantly less postoperative pain and mouth odor were reported for both Cleocin (P = 0.014 and P = 0.005, respectively) and Augmentin/Timentin (P = 0.026 and P = 0.05, respectively) topical treatment groups when compared with the placebo group.


CONCLUSIONS
Preliminary results indicate a reduction in oral bacterial counts and postoperative morbidity in adult patients receiving topical antibiotics compared with patients receiving placebo; further investigation is warranted.
Mann
E A
EA
Division of Otolaryngology-Head and Neck Surgery, Walter Reed Army Medical Center, Washington, DC 20307, USA.
Blair
E A
EA
Levy
A J
AJ
Chang
A
A
D000287:Administration, Topical; D000328:Adult; D000658:Amoxicillin / Q000008:administration & dosage; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000008:administration & dosage; D000667:Ampicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis; D001419:Bacteria / Q000254:growth & development; D002969:Clavulanic Acids / Q000008:administration & dosage; D002981:Clindamycin / Q000008:administration & dosage; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D009055:Mouth / Q000382:microbiology; D009067:Mouthwashes; D010865:Pilot Projects; D011183:Postoperative Complications / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000517:prevention & control; D013982:Ticarcillin / Q000008:administration & dosage; D014068:Tonsillectomy
D000900:Anti-Bacterial Agents; D002969:Clavulanic Acids; D009067:Mouthwashes; D002981:Clindamycin; D019980:Amoxicillin-Potassium Clavulanate Combination; D000667:Ampicillin; D000658:Amoxicillin; C043215:ticarcillin-clavulanic acid; D013982:Ticarcillin