Perlu tidaknya pemberian antibiotik profilaksis setelah tonsillectomy atau tonsilektomi masih sering menjadi perdebatan, karena beberapa studi menyatakan bahwa antibiotik profilaksis dapat mengurangi risiko komplikasi pascaoperasi, sedangkan beberapa studi lain menyatakan bahwa antibiotik profilaksis tidak bermanfaat.[1,2]
Tonsillectomy adalah pembedahan untuk mengangkat tonsil, yang umumnya dilakukan untuk pasien tonsilitis rekuren dan pasien obstructive sleep apnea. Tindakan ini terutama sering dilakukan pada anak-anak. Data dari Amerika Serikat menunjukkan bahwa 3,4–4,8 dari 1.000 anak berusia <18 tahun pernah menjalani tonsillectomy.[2-4]
Namun, tonsillectomy bukanlah suatu tindakan yang bebas risiko. Setelah tonsillectomy, pasien mungkin mengalami komplikasi seperti infeksi, perdarahan, disfagia, odinofagia, otalgia, dan dehidrasi. Pemberian antibiotik profilaksis diharapkan dapat mengurangi risiko komplikasi dan durasi rawat inap. Namun, bukti tentang manfaat ini sebenarnya masih terbatas. Ada kekhawatiran bahwa pemberian antibiotik pada semua pasien tonsillectomy justru berisiko menimbulkan efek samping dan resistansi mikroba.[2-4]
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Referensi
1. AbdElrahman NH, et al. The use of postoperative antibiotics in tonsillectomy: a comparative study. The Egyptian Journal of Hospital Medicine. 2022;88:4081-4084.
2. Junaid M, Malik NW, et al. To give or not to give? Prescribing antibiotics to the tonsillectomy patients in a tertiary care setting. Cureus. 2021. doi: 10.7759/cureus.16405
3. Shah S, et al. A study to assess the outcomes following tonsillectomy in patients who were administered only prophylactic pre-operative antibiotics vis-à-vis patients who were administered both pre and post-operative antibiotics. International Journal of Otorhinolaryngology and Head and Neck. 2021;7(2):354-357.
4. Kim SY, Min C, Lee WH, et al. Tonsillectomy increases the risk of retropharyngeal and parapharyngeal abscesses in adults, but not in children: A national cohort study. Plos One. 2018. doi: 10.1371/journal.pone.0193913
5. Rigotti E, et al. Antimicrobial prophylaxis in neonates and children undergoing dental, maxilla-facial or ear-nose-throat (ENT) surgery: A RAND/UCLA appropriateness method consensus study. Antibiotics. 2022;11(3):382. https://doi.org/10.3390/antibiotics11030382
6. Mitchell RB, et al. Clinical practice guideline: tonsillectomy in children (update). American Academy of Otolaryngology–Head and Neck Surgery Foundation. 2019;160:S1–S42. doi: 10.1177/0194599818801757
7. Jocum J. Surgical antibiotic prophylaxis: are you doing it right?. Southern African Journal of Anaesthesia and Analgesia. 2018;24(3).
8. Nae A, Khan MH, Heffernan CB, Keogh IJ. Are intravenous antibiotics routinely indicated in the management of secondary post tonsillectomy haemorrhage?. Saudi J Otorhinolaryngol Head Neck Surg. 2022;24:157-62.
9. Tshifularo MI, Montana GM. The role of antibiotics in post tonsillectomy morbidity: an experience at tertiary centre, steve biko academic hospital, university of pretoria. J Otolaryngol Res. 2018;1;201.
10. Katundu D, et al. Effect of placebo versus prophylactic postoperative amoxicillin on post-(adeno) tonsillectomy morbidity in Tanzanian children: a two-centre, double-blind randomized controlled non-inferiority trial. Pan African Medical Journal. 2022;42(142). doi: 10.11604/pamj.2022.42.142.35540.
11. Romandini A, et al. Antibiotic resistance in pediatric infections: Globat emerging threats, predicting the near future. Antibiotics (Basel). 2021. doi: 10.3390/antibiotics10040393