Article Sidebar
Main Article Content
Abstract
Introduction
L’amygdalectomie, reste controversée notamment au sujet de l’intérêt de l’utilisation de l’antibiothérapie en post opératoire. Une étude interventionnelle a été menée, dans le but d’évaluer l’influence de l’antibiothérapie post opératoire dans la morbidité en post opératoire.
Méthodes
L’échantillon a été constitué de patients de l’Hôpital Laquintinie de Douala, avec un échantillonnage consécutif. Les patients ont été divisés en deux groupes, le premier placé sous antibiothérapie et le second sans antibiotiques servait de contrôle. .La collecte des données a été faite à l’aide d’un questionnaire prétesté, par des interviews individualisées et les constatations des visites médicales pendant les jours de contrôle. Les variables quantitatives ont été comparées grâce au test ANOVA.
Résultats
Cent patients ont été inclus dans cette étude. L’âge moyen a été de 17± 3,2 ans avec un ratio H/F de 0,61. Aucune variation significative de la température, du pouls et de la tension artérielle n’a été notée entre les deux groupes. Au premier jour post opératoire 60 (96,8%) patients sous antibiothérapie, contre 26 (94,7%) sans antibiotiques ne se sont pas plaint d’une augmentation de la douleur, avec une différence statistiquement non significative (IC : 0,04 - 8,65 ; OR : 0,6 ; P=0,63). Au quinzième jour post opératoire, aucun patient du deuxième groupe ne ressentait plus de douleur contre deux patients (3,2%) du premier groupe qui ressentaient une légère douleur (IC : 0 - 8,7 ; OR : 0 ; P= 0,52).
Conclusion
L’utilisation d’une antibiothérapie pour le suivi post opératoire des amygdalectomies, n’influence pas significativement l’avènement des épisodes de morbidité dans notre contexte.
SUMMARY
Introduction
Tonsillectomy still remains controversial in many ways, especially vis-à -vis the interest in the use of antibiotic therapy after surgery. An interventional study was conducted in order to evaluate the influence of post operative antibiotherapy on the post operative morbidity.
Methods
Our sample comprised patients of Laquintinie Hospital Douala. Sampling method was consecutive. Patients were divided into two groups: one receiving post operative antibiotics and the second group, without antibiotics was used as a control. Data collection was done using a pre- tested questionnaire, by individualized interviews and clinical observations during the days of check up. Descriptive statistics data were used. The ANOVA test was used to compare means.
Results
One hundred patients were included in this study. The mean age was 17 ± 3.2 years with an M / F ratio of 0.61. We noted no significant change in temperature, pulse rate and diastolic blood pressure between the two groups. On the first day, 60 (96.8 %) patients treated with antibiotics, against 26 (94.7%) without antibiotics did not complain of increased pain with a difference not statistically significant (CI: 0.04 to 8, 65, OR = 0.6, P = .63). On day fifteenth day, no patient in group 2 no longer felt pain; but two patients ( 3.2%) in the group with antibiotics felt a slight pain (CI: 0 to 8.7 , OR: 0 , P = 0.52).
Conclusion
The use of antibiotic therapy for post -operative tonsillectomies follow up does not influence the onset of episodes of morbidity in our context.
Article Details
References
- REFERENCES
- - Taylan I, Ozcan I, Mumcuoğlu I et al. Comparison of the surface and core bacteria in tonsillar and adenoid tissue with Beta-lactamase production. Indian J Otolaryngol Head Neck Surg. 2011 Jul; 63(3):223-8.
- - Lennon P, Amin M, Colreavy MP. A prospective study of parents' compliance with their child's prescribed analgesia following tonsillectomy. Ear Nose Throat J, 2013 Mar; 92(3):134-40.
- - Sarny S, Habermann W, Ossimitz G, Stammberger H. Significant post-tonsillectomy pain is associated with increased risk of hemorrhage. Ann Otol Rhinol Laryngol. 2012 Dec; 121(12):776-81.
- - Mui S, Rasgon BM, Hilsinger RL et al. Efficacy of tonsillectomy for recurrent throat infection in adults. Laryngoscope 1998; 108(9):1325-8.
- - Bhattacharyya N, Kepnes LJ, Shapiro J. Efficacy and quality-of-life impact of adult tonsillectomy. Arch Otolaryngol Head Neck Surg 2001; 127(11):1347-50.
- - Waridel F, Krahenbuhl J-D, Cherpillod J. Tonsillotomie ou tonsillectomie chez l’enfant : complications et efficacité. Schweiz Med Forum 2005;5(Suppl. 22):64-5.
- - Browning GG. Prophylactic steroids and/or antibiotics to reduce post-tonsillectomy morbidity: a yet unanswered conundrum. in Otolaryngol. 2010 Oct; 35(5):417
- - Legent F, Arnould JF. Antibiotic prophylaxis in ORL surgery and oral medicine. Ann Fr Anesth Reanim. 1994; 13
- - Dhiwakar M, Clement WA, Supriya M, McKerrow W. Antibiotics to reduce post tonsillectomy morbidity. Eur Arch Otorhinolaryngol. 2013 Jan; 270(1):367-70.
- - Stephens JC, Georgalas C, Kyi M, Ghufoor K. Is bacterial colonisation of the tonsillar fossa a factor in post-tonsillectomy haemorrhage? J Laryngol Otol. 2008 Apr; 122(4):383-7.
- - Okafor UV, Nwosu JN, Onyekwulu FA. Postoperative vomiting and fever following tonsillectomy in Enugu, Nigeria. Niger J Med. 2013 Jan-Mar; 22(1):45-7.
- - Magdalena ML, Caragol L, Solé A, Suárez V, Cillero JA, Rodrigo JP. Protocol for post-tonsillectomy pain control in outpatient adults. Acta Otorrinolaringol Esp. 2013 Mar 16.
- - Bhattacharyya N, Kepnes LJ. Economic benefit of tonsillectomy in adults with chronic tonsillitis. Ann Otol Rhinol Laryngol 2002; 111(11):983-8.
- - Van Staaij BK, Van Den Akker EH, Van Der Heijden GJMG, Schilder AG, Hoes AW. Adenotonsillectomy for upper respiratory infections: evidence based? Arch Dis Child 2005; 90: 19-25.
- - Colreavy MP, Nanan D, Benamer M, et al. Antibiotic prophylaxis post-tonsillectomy: is it of benefit? Int J Pediatr Otorhinolaryngol 1999; 50: 15-22.
- - Al-Layla A, Mahafza TM. Antibiotics do not reduce post-tonsillectomy morbidity in Eur Arch Otorhinolaryngol. 2013 Jan; 270(1):367-70.
- - Baloch MA, Akhtar S, Ikram M, Humayun. The rationality of prescribing antibiotics after tonsillectomy. J Pak Med Assoc. 2012 May; 62(5):445-7.
- - Lee WC, Duignan MC, Walsh RM, McRae-Moore JR. An audit of prophylactic antibiotic treatment following tonsillectomy in children. J Laryngol Otol 1996; 110(4) 357-9.
References
REFERENCES
- Taylan I, Ozcan I, Mumcuoğlu I et al. Comparison of the surface and core bacteria in tonsillar and adenoid tissue with Beta-lactamase production. Indian J Otolaryngol Head Neck Surg. 2011 Jul; 63(3):223-8.
- Lennon P, Amin M, Colreavy MP. A prospective study of parents' compliance with their child's prescribed analgesia following tonsillectomy. Ear Nose Throat J, 2013 Mar; 92(3):134-40.
- Sarny S, Habermann W, Ossimitz G, Stammberger H. Significant post-tonsillectomy pain is associated with increased risk of hemorrhage. Ann Otol Rhinol Laryngol. 2012 Dec; 121(12):776-81.
- Mui S, Rasgon BM, Hilsinger RL et al. Efficacy of tonsillectomy for recurrent throat infection in adults. Laryngoscope 1998; 108(9):1325-8.
- Bhattacharyya N, Kepnes LJ, Shapiro J. Efficacy and quality-of-life impact of adult tonsillectomy. Arch Otolaryngol Head Neck Surg 2001; 127(11):1347-50.
- Waridel F, Krahenbuhl J-D, Cherpillod J. Tonsillotomie ou tonsillectomie chez l’enfant : complications et efficacité. Schweiz Med Forum 2005;5(Suppl. 22):64-5.
- Browning GG. Prophylactic steroids and/or antibiotics to reduce post-tonsillectomy morbidity: a yet unanswered conundrum. in Otolaryngol. 2010 Oct; 35(5):417
- Legent F, Arnould JF. Antibiotic prophylaxis in ORL surgery and oral medicine. Ann Fr Anesth Reanim. 1994; 13
- Dhiwakar M, Clement WA, Supriya M, McKerrow W. Antibiotics to reduce post tonsillectomy morbidity. Eur Arch Otorhinolaryngol. 2013 Jan; 270(1):367-70.
- Stephens JC, Georgalas C, Kyi M, Ghufoor K. Is bacterial colonisation of the tonsillar fossa a factor in post-tonsillectomy haemorrhage? J Laryngol Otol. 2008 Apr; 122(4):383-7.
- Okafor UV, Nwosu JN, Onyekwulu FA. Postoperative vomiting and fever following tonsillectomy in Enugu, Nigeria. Niger J Med. 2013 Jan-Mar; 22(1):45-7.
- Magdalena ML, Caragol L, Solé A, Suárez V, Cillero JA, Rodrigo JP. Protocol for post-tonsillectomy pain control in outpatient adults. Acta Otorrinolaringol Esp. 2013 Mar 16.
- Bhattacharyya N, Kepnes LJ. Economic benefit of tonsillectomy in adults with chronic tonsillitis. Ann Otol Rhinol Laryngol 2002; 111(11):983-8.
- Van Staaij BK, Van Den Akker EH, Van Der Heijden GJMG, Schilder AG, Hoes AW. Adenotonsillectomy for upper respiratory infections: evidence based? Arch Dis Child 2005; 90: 19-25.
- Colreavy MP, Nanan D, Benamer M, et al. Antibiotic prophylaxis post-tonsillectomy: is it of benefit? Int J Pediatr Otorhinolaryngol 1999; 50: 15-22.
- Al-Layla A, Mahafza TM. Antibiotics do not reduce post-tonsillectomy morbidity in Eur Arch Otorhinolaryngol. 2013 Jan; 270(1):367-70.
- Baloch MA, Akhtar S, Ikram M, Humayun. The rationality of prescribing antibiotics after tonsillectomy. J Pak Med Assoc. 2012 May; 62(5):445-7.
- Lee WC, Duignan MC, Walsh RM, McRae-Moore JR. An audit of prophylactic antibiotic treatment following tonsillectomy in children. J Laryngol Otol 1996; 110(4) 357-9.