The Efficacy of Perioperative Antibiotic Therapy in Adenotonsillectomy Children

Abstract

Abstract Purpose: This prospective study was to evaluate the role of perioperative antibiotics use in children after adenotonsillectomy. Methods: A total of 246 children undergoing adenotonsillectomy admitted to our department from September 6th 2021 to September 5th 2022 were collected and randomly divided into observation group (128 cases) and control group (118 cases). The observation group received ampicillin sulbactam sodium intravenously 30min before and the day after surgery, while the control group was given saline instead. SPSS 27.0 was used for statistical analysis. Two independent samples mean T-test was used to evaluate the throat pain scores consecutive 3 days after the surgery, the time to resume to normal diet and the wound healing time between the two groups. Logistic regression analysis was used to evaluate the independent risk factors of the two groups. The generalized estimation model was used to evaluate the correlation between age and postoperative pain scores and the relationship between the different tonsillar bed grading and postoperative pain scores. Results: The pain scores were 5.83±1.879, 5.20±1.933 and 4.02±1.936 in the observation group and 6.83±1.892, 6.17±2.001 and 5.29±2.068 in the control group on day 1 to 3 after surgery, respectively. The difference between the two groups was statistically significant (P<0.01); The time of pain disappearance was (6.24±2.121) d in the observation group and (7.73±2.210) d in the control group, and the difference between the two groups was statistically significant (P<0.01). The wound repair time was (18.66±2.200) d in the observation group and (18.70±2.468) d in the control group. There was no significant difference between the two groups (P =0.874). Logistic regression analysis showed that fever was an independent risk factor for the two groups and was negatively correlated (B=-1.237, P<0.001, OR=0.290); Generalized estimation model showed that there was a positive correlation between age and pain scores (P<0.001) and with the increasing grading of tonsillar bed, the higher the pain scores was (P<0.001). Conclusions: Perioperative use of antibiotics in children with adenotonsillectomy can effectively reduce postoperative fever, throat pain symptoms and shorten the pain time. With the increasing of tonsillar bed grading, perioperative antibiotic therapy was more necessary.