Utility of prophylactic antibiotics in pediatric adenoidectomy

SummaryObjectiveTo determine the utility of prophylactic antibiotics in non-risk pediatric patients undergoing adenoidectomy.MethodsWe performed a prospective, controlled, randomized, and double-blind study on patients under 14 years of age, scheduled for adenoidectomy who accomplished the following criteria: absence of immunossuppresive and/or cardiovascular risk factors, no antimicrobial therapy for at least 15 days prior to operation, and no fever 1 week before surgery. Venous blood samples for culture were obtained at 30 s and 20 min after the curettage of adenoidal tissue. Likewise, immediate and delayed complications were registered in all cases. The usefulness of prophylaxis was analyzed according to three major standpoints: bacteremia, immediate complications, and delayed complications.ResultsOne-hundred one patients fulfilled the inclusion criteria and were included in the study. Fifty-one children received prophylaxis and the remainder did not. In the non-prophylactic group incidence of bacteremia at 30 s was significantly higher than in the prophylactic group (32.7% versus 4.0%) (p < 0.001). Neither bacteremia at 20 min, nor immediate or delayed complications showed statistical differences between both treatment groups.ConclusionsPreoperative antimicrobial prophylaxis in pediatric adenoidectomy did not offer advantages preventing complications in non-risk patients. Only bacteremia that occurs 30 s after the curettage of adenoid tissue is reduced with the employment of prophylactic antibiotics.