The effect of amoxycillin on Morbidity after paediatric Adenotonsillectomy at Kenyatta National Hospital, Nairobi Kenya

Abstract

Adenoidectomy, tonsillectomy or adenotonsillectony continues to be commonly performed in most 'Ear, Nose and Throat (ENT) Units especially in the paediatric age group. Though it is generally safe surgery there are potential complications, which the surgeon should be prepared to manage. The post operative period is characterized by sore throat, otalgia, fever, dehydration, and foul odour from the oral cavity. Though post-operative sepsis is a potential complication there is no clear guidelines on the use of antibiotics and there is a possibility that antibiotics may be over used. Patients are routinely put on amoxycillin post-operatively after adenotonsillectomy in Kenyatta National Hospital ENT Unit. No study, in our set up has been done to demonstrate the role of antibiotics after adenotonsillectomy. A prospective double blind randomized study was done in Kenyatta National Hospital (KNH) ENT Unit. Amoxycillin (or placebo) was administered to all children undergoing adenoidectomy, tonsillectomy or adenotonsillectomy for a period of one week. The children were then monitored and evaluated for the incidence and severity of post-operative complications if any. All patients were given intra-operative start dose of dexamethasone (0.1 mg./kg) and paracetamol (10mg./kg). They continued with paracetamol for one week