The aim of a systematic review study by M. Dhiwakar et al. (United Kingdom), was to determine whether perioperative antibiotic prophylaxis affects the recovery rate after tonsillectomy.

Data collection was carried out in the Medline, Embase databases and the Cochrane Central Register of Controlled Trials. In addition, a study was conducted on links to all selected clinical and review studies, as well as newsletters, articles and conference papers.

The review included data from five randomized, placebo-controlled, double-blind studies that met the current quality criteria that examined the effectiveness of antibiotic prophylaxis intra and / or perioperatively in children or adults who underwent tonsillectomy or an adenotonzylectomy. The analysis of the research results was carried out according to the following indicators: 1) pain, need to use painkillers, fever, bad breath, time of return to a good diet and normal activity; 2) secondary bleeding (presence of at least 2 signs: need for readmission, blood transfusion or hemostasis) or total bleeding; 3) the development of adverse events.

According to the results, antibiotic prophylaxis was accompanied by a significant decrease in the frequency of increase in body temperature in patients (relative risk 0.62 [95% confidence interval 0.45, 0.85] ) and the duration of halitosis (1.94 [-3.57, -0.30] days), as well as a slight decrease in recovery time for normal activity (-0.63 [- 1.12, -0.14] days), but had no significant effect on reducing the severity of pain (-0.01 [-0.60, 0.57]) and need painkillers. There were no significant differences in the timing of return to normal diet and the frequency of bleeding, which may be due to insufficient sample size.

In patients receiving antibacterial drugs, adverse events developed in 4 cases (3 episodes of rash and 1 oropharyngeal candidiasis), while in the control group an episode of occurrence of an undesirable phenomenon (rash) a been noted. The relative risk of developing adverse events while taking antibiotics was 2.45 [0.45, 13.31].

Thus, perioperative antibiotic prophylaxis helps reduce the side effects of tonsillectomy, but not all, but comes with an increased risk of adverse events. More studies are needed to clarify the role of antibacterial drugs in the healing process of patients after this procedure.