No Difference in Pain or Febrile Episodes With the Use of Post-Operative Antibiotics in Paediatric Coblation Intracapsular Tonsillectomy for Sleep-Disordered Breathing or Recurrent Tonsillitis: A Prospective Randomised Trial

Objective Coblation technology is gaining wide acceptance and use as a contemporary surgical technique for tonsil surgeries due to less post-operative morbidity compared to the more traditional total tonsillectomy. Previous articles examined the role of post-operative antibiotics for traditional total tonsillectomy; however, this is the first study which explores the role of post-operative prophylactic antibiotic treatment among children undergoing coblation intracapsular tonsillectomy. Methods A prospective randomised study included 100 children (aged 1-16) who were divided into two subgroups: with and without post-operative antibiotics. Post-operative follow-up of patients included assessment for 7 days of pain levels, fever, return to diet, bleeding and halitosis. In addition, the children's caregivers completed the Parents'-Postoperative-Pain-Measure (PPP-M) questionnaire on Days 1 and 7. Results The (+) antibiotic subgroup had substantially less halitosis on Days 2-6 after surgery. Prophylactic antibiotic treatment did not yield any differences between the two subgroups in the incidence of fever, return to regular diet or drinking, pain as measured by the Wong Baker Faces Pain scale, or pain as reported by the parents on the PPP-M questionnaire. Conclusions This prospective study highlights that routine prophylactic post-operative antibiotic use has a limited clinical benefit in paediatric intracapsular tonsillectomy. Improvement in halitosis was significant with antibiotic treatment; however, various other clinical parameters did not differ between the two subgroups, so the routine use of post-operative antibiotics in the above setting is discouraged.