Limited role for antibiotics post-tonsillectomy

Clinical question: 
How effective are antibiotics in reducing post-tonsillectomy morbidity?
Bottom line: 
Antibiotics do not reduce pain, bleeding, the need for painkillers or the time taken to resume normal diet and activities following tonsillectomy in adults or children.┬╣ They do however appear to reduce fever, but this relatively minor benefit is more likely due to weaknesses in the studies themselves rather than any direct antibiotic effect.
The risk of adverse effects such as skin rashes and diarrhoea are slightly higher in patients who are prescribed antibiotics.
Tonsillectomy is a commonly performed operation in children and adults. In the UK only 12% of ENT specialists routinely prescribe antibiotics┬╣, compared to 79% in the USA.┬▓ Following the operation, nearly all patients experience significant pain, need regular painkillers, and are unable to resume normal diet and activities for a few hours to several days. 1. Dhiwikar M et al. Journal of Laryngology and Otology 2005 ;119 :614-619. 2. Krishna P et al. International Journal of Paediatric Otorhinolaryngology 2004 ;68 :779-784.
Review CD#: 
May, 2008
Authored by: 
Brian R McAvoy