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Year : 2022  |  Volume : 24  |  Issue : 4  |  Page : 157-162

Are intravenous antibiotics routinely indicated in the management of secondary post tonsillectomy haemorrhage?

1 Department of Otolaryngology-Head and Neck Surgery, University College Hospital Galway; Surgical Department, School of Medicine, National University of Ireland Galway, Galway, Ireland
2 Department of Otolaryngology-Head and Neck Surgery, Children's Health Ireland at Temple Street Hospital, Dublin, Ireland

Correspondence Address:
Ms. Andreea Nae
Department of Otolaryngology-Head and Neck Surgery, University College Hospital Galway, Galway
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sjoh.sjoh_49_22

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Objective: To review secondary posttonsillectomy hemorrhage (SPTH) patients in our unit, assess them for evidence of infection and make recommendations about the routine use of intravenous (iv) antibiotics. Methods: Retrospective review of our departmental tonsillectomy database over 3 consecutive years. Inflammatory markers, temperature, and throat swab results were analyzed. Results: 3160 tonsillectomies were performed; 1856 on children. The patient's age range 273 years. One hundred and twenty-three SPTH cases were recorded (3.9% rate), with a slight female preponderance (61%). All received broad-spectrum IV antibiotics. Twenty percent of SPTH presented on the 5th postoperative day (range days 227). Eighty-four-and-a-half percent of patients had no clinical or laboratory evidence of infection. Nineteen (15.5%) patients had elevated C reactive protein, white cell count, and neutrophils. Forty patients had throat swabs performed with no pathogens isolated. Conclusions: Clinical signs of infection are uncommon in SPTH. The decision to use iv antibiotics in SPTH should be on an individual basis, guided by clinical and laboratory findings.

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