RANDOMIZED COMPARATIVE STUDY OF THE USE OF AZITHROMYCIN AND IBUPROFEN IN PAIN AND POSTADENOTONSILLECTOMY COMORBIDITIES DURING CHILDHOOD

Introduction: The adenotonsillectomy is among the most usual surgical procedures during childhood. Postoperative pain in this type of surgery may be intense and long-lasting. It is a major obstacle against the return to the reasonable feeding condition because it makes swallowing more difficult. The nonsteroidal anti-inflammatory drugs (NSAIDs) are the most used group of medications for the treatment of acute pain, as they are considered safe, also due to their low cost and because they do not need any unique prescription. Azithromycin is an antibiotic of the macrolide group that can not only act as antimicrobial, but also as an anti-inflammatory. It has been observed that the macrolide drugs lower the production of cytokines, stimulate degranulation of the leucocytes, gather neutrophil and blood flow cells exposed to bacteria, and also accelerate the apoptosis of the leucocytes, which are typical effects of classical anti-inflammatory drugs. Objective: Aiming to assess these effects, a randomized comparative study in two groups of children undergoing adenotonsillectomy was performed. Material and Methods: Group 1 received ibuprofen in the postoperative, and group 2 received ibuprofen and azithromycin. Both groups were assessed as to immediate postoperative pain, at the moment of hospital discharge (4 to 6 hours after the surgery), on the 5th, 10th, and 14th postoperative day. The number of doses administered against pain, discomfort at the time of swallowing, and return to feeding, as well as postoperative comorbidities (fever, nausea, vomiting, and bleeding) were also observed. Results: The results did not show statistical significance between the groups. Conclusion: It was concluded that azithromycin did not lower postoperative pain; it does not make swallowing easier, and does not act over the comorbidities. More detailed studies must be made to better evaluate the effect of azithromycin as an anti-inflammatory in the adenotonsillectomy postoperative.