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Report Finds Tonsillectomy Care Varies Greatly Across Hospitals

Update Date: Jan 20, 2014 03:49 PM EST
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A tonsillectomy, which is a procedure that removes the tonsils, is one of the most common and routine surgeries for young children. Despite how routine this surgery might be, a new study is reporting that the types of medications doctors prescribe children during and after the tonsillectomy vary greatly across the nation.

"It's not surprising that we found variation among hospitals," Dr. Sanjay Mahant said according to Medical Xpress. "But the degree of the variation was [surprising]."

For this study, the researchers examined how 36 children's hospitals dealt with standard tonsillectomies. They looked at the use of antibiotics and the steroid, dexamethasone, which is often used to control nausea and pain after the surgery. Studies have found that dexamethasone was effective whereas there is little to no evidence that antibiotics work in treating patients undergoing tonsillectomies. The data came from hospitals' records between 2004 and 2010, which was before the American Academy of Otolaryngology - Head and Neck Surgery recommended the use of one dose of dexamethasone.

The researchers found that dexamethasone was administered 75 percent of the time. Despite this frequency, the researchers found that the data revealed a wide range between hospitals. Some hospitals never gave the steroid whereas others gave it to almost every child. For antibiotics, the researchers calculated that around an average of 16 percent of children were given antibiotics. The researchers found that there was a wide discrepancy for antibiotic treatment as well.

"We're not expecting a zero rate of antibiotic use," said Dr. Richard Rosenfeld, the director of the Institute for Advanced Otolaryngology at New York Methodist Hospital. Rosenfeld was involved with the 2011 guidelines. "Dexamethasone should be routine. What you get from a single IV dose is pretty impressive. Over the first 24 hours, it cuts the risk of vomiting by 50 percent and reduces pain by about 25 percent."

The researchers stated that if parents ask about dexamethasone, it could increase the usage of the drug. The study was published in Pediatrics.

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