Role of postoperative antibiotics after appendectomy in non-perforated appendicitis

J Coll Physicians Surg Pak. 2012 Dec;22(12):756-9.

Abstract

Objective: To determine the role of postoperative antibiotics in reducing the surgical site infections (SSIs) after open appendectomy in patients with non-perforated appendicitis (NPA).

Study design: Randomized controlled trial.

Place and duration of study: The Department of Surgery, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia, from January 2010 to July 2011.

Methodology: Three hundred and seventy seven patients, who underwent appendectomy for NPA and fulfilled the selection criteria, were randomized into two groups. The patients in group A received a single dose of pre- operative antibiotics (cefuroxime sodium and metronidazole), while the group B patients received one more dose of the same antibiotics postoperatively. Patients of both the groups were followed-up for 30 days to assess the postoperative infective complications.

Results: Group A had 195, while group B comprised of 182 patients. The groups were comparable in the baseline characteristics. Statistically there was no significant difference in rates of SSIs between both the groups (p = 0.9182). Mean hospital stay was 2.29 ± 0.81 and 2.35 ± 0.48 days for group A and B respectively (p = 0.4403). None of the patients developed intraabdominal collection.

Conclusion: Single dose of pre-operative antibiotics (cefuroxime and metronidazole) was sufficient in reducing the SSIs after appendectomy for NPA. Postoperative antibiotics did not add an appreciable clinical benefit in these patients.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Antibiotic Prophylaxis / methods*
  • Appendectomy
  • Appendicitis / surgery*
  • Cefuroxime / administration & dosage
  • Cefuroxime / therapeutic use
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Length of Stay
  • Male
  • Metronidazole / administration & dosage
  • Metronidazole / therapeutic use
  • Middle Aged
  • Postoperative Care / methods*
  • Postoperative Complications / prevention & control
  • Postoperative Period
  • Saudi Arabia
  • Surgical Wound Infection / drug therapy
  • Surgical Wound Infection / prevention & control*
  • Time Factors
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Metronidazole
  • Cefuroxime