Post-tonsillectomy bacteraemia

Abstract

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. The aim of this study has been to assess the incidence of post-tonsillectomy bacteraemia, identify the organisms associated with it and review the suitability of penicillin in prophylactic regimens. Of the 32 patients included in the study, 11 (34.4%) had positive post-tonsillectomy blood cultures. We were surprised at this low incidence of bacteraemia and have postulated a possible reason. Haemophilus influenzae was isolated from 4 (36.4%) of the positive cultures and Streptococcus viridans in only 1 (9%). Rather than using penicillin for prophylaxis a beta-lactamase stable antibiotic would be more appropriate.