No Reduction in Infections With Immediate Adenoidectomy

Similar number of respiratory infections in children who have immediate surgery, watchful waiting

WEDNESDAY, Sept. 7 (HealthDay News) -- Children who are selected for adenoidectomy for recurrent upper respiratory tract infections and undergo immediate adenoidectomy have the same number of infections per person-year as those who undergo an initial watchful watching, according to a study published online Sept. 6 in BMJ.

Maaike T.A. van den Ardweg, M.D., from the University Medical Center Utrecht in the Netherlands, and colleagues investigated the effectiveness of adenoidectomy in 111 children aged 1 to 6 years with recurrent upper respiratory tract infections selected for adenoidectomy. The children were assigned to immediate adenoidectomy with or without myringotomy or initial watchful waiting. The number of upper respiratory tract infections per person-year at a maximum of 24 months follow-up was the primary outcome. Days with upper respiratory tract infection per person-year, middle-ear complaints with fever in episodes and days, days with fever, prevalence of upper respiratory tract infections, and health-related quality of life were the secondary outcomes.

The investigators found that there were 7.91 and 7.84 episodes of respiratory tract infections per person-year in the adenoidectomy and the watchful waiting groups, respectively. There were no relevant differences seen between the two groups for days of upper respiratory tract infections, middle-ear complaints with fever in episodes and days, or health-related quality of life. Decreased prevalence of upper respiratory tract infections over time was found in both groups. Significantly more days with fever were found among children in the adenoidectomy group than those in the watchful waiting group.

"A strategy of immediate surgery confers no clinical benefits over a strategy of initial watchful waiting," the authors write.

Two authors disclosed financial ties to GlaxoSmithKline.

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