[The clinical importance of bacteremia during tonsillectomy].

INTRODUCTION

Post-tonsillectomy bacteraemia is a well recognized aetiological factor in streptococcal endocarditis. Prophylactic penicillin has been recommended to reduce its incidence in susceptible patients undergoing tonsillectomy. Recent studies have shown a change in the microflora and an increase in the number of penicillin-resistant organisms in the tonsils of patients undergoing tonsillectomy.

OBJECTIVE

The aim of this study was to assess the incidence of post-tonsillectomy bacteraemia, identify the associated organisms, and review the suitability of penicillin in prophylactic regimens.

MATERIAL AND

METHODS

102 children were included. Blood culture samples were taken after removal of the first tonsil, which was randomly electrodissected or blunt dissected. Statistical analysis was performed using ANOVA.

RESULTS

Of the 102 patients included in the study, 41 (40.1%) had positive post-tonsillectomy blood cultures. Haemophilus influenzae was isolated from 23 (56%) of the positive cultures and Streptococcus viridans from 15 (36.5%). Twenty-five percent of H. influenzae and 50% of the viridans group produced beta-lactamase.

CONCLUSIONS

A beta-lactamase stable antibiotic would be more appropriate than penicillin for prophylaxis during tonsillectomy.