The following is a summary of “Effect of prophylactic amoxicillin on tonsillar bacterial pathogens after (adeno)tonsillectomy in children,” published in the August 2023 issue of Infectious Disease by Katundu et al.

Inappropriate and unnecessary antibiotic use is a growing global health concern. Despite evidence to the contrary, prophylactic antibiotics are frequently used in (adeno)tonsillectomy (AT) in contexts with limited resources. This study examined the effect of prophylactic amoxicillin administered after AT in infants. 

This is a secondary analysis from a two-center, double-blind, randomized, controlled, non-inferiority trial designed to examine the effect of prophylactic amoxicillin on post-AT morbidity. Children aged 2 to 14 years with recurrent chronic tonsillitis and obstructive sleep apnea were randomly assigned to receive amoxicillin or a placebo for five days following surgery. Before and after tonsillectomy, samples were obtained for polymerase chain reaction (PCR) testing to identify the five most prevalent pathogens known to cause tonsillitis. Before and after surgery, as well as between placebo and amoxicillin, PCR results were compared. 

Around 109 positive PCR results were in the amoxicillin group and 115 in the placebo group. About 91% of patients in the amoxicillin group had at least one positive PCR test before surgery, and 87% had at least one positive test after surgery. The respective percentages in the placebo group were 92% and 90%. Following surgery, the total number of pathogens decreased in both categories. Compared to placebo, prophylactic amoxicillin administered after AT to children had no clinically significant effect on the number of oropharyngeal microorganisms.

Source: sciencedirect.com/science/article/pii/S1201971223005404