Tonsillectomy is a commonly performed operation in children and adults. Following the operation nearly all patients experience significant pain, need regular painkillers and are unable to resume normal diet and activities for several hours. Rarer but more dangerous complications, such as bleeding from the operated area, also occur. Antibiotics are commonly prescribed to reduce some or all of these undesirable consequences of tonsillectomy.
The present review, however, suggests that antibiotics do not reduce pain, the need for painkillers or bleeding. They do, however, appear to reduce fever. This relatively minor benefit is more likely to be due to weaknesses in the studies themselves than any direct antibiotic effect. The risk of adverse events, such as skin rash and diarrhoea, is also slightly higher in patients who were prescribed antibiotics. Therefore, in the absence of clear-cut and significant benefit and with the potential for harm, we advocate against prescribing antibiotics routinely for patients undergoing tonsillectomy.