The outcome measures of the studies were : Wound infection , intra abdominal abscess , length of stay in hospital , and mortality .
The overall result is that the use of antibiotics is superior to placebo for preventing wound infection and intraabdominal abscess , with no apparent difference in the nature of the removed appendix .
Studies exclusively on children and studies examining topical application reported results in favour to the above , although the results were not significant .
Antibiotic prophylaxis is effective in the prevention of postoperative complications in appendectomised patients , whether the administration is given pre- , peri- or post-operatively , and could be considered for routine in emergency appendectomies
BACKGROUND Appendicitis is the most common cause of acute abdominal pain requiring surgical intervention .
The cause of appendicitis is unclear and the mechanism of pathogenesis continues to be debated .
Despite improved asepsis and surgical techniques , postoperative complications , such as wound infection and intraabdominal abscess , still account for a significant morbidity .
Several studies implicate that postoperative infections are reduced by administration of antimicrobial regimes .
OBJECTIVES This review evaluated the use of antibiotics compared to placebo or no treatment in patients undergoing appendectomy .
Will these patients benefit from antimicrobial prophylaxis ?
The prevention of post-appendicectomy sepsis by metronidazole and cefazolin: a controlled double blind trial.
A double blind , r and omized , controlled trial was carried out at two hospitals to try the effect of metronidazole , which is effective against most anaerobes , and cefazolin , which is effective against many aerobic organisms , singly and in combination , on the incidence of wound sepsis following appendicectomy . Patients were placed at r and om into one of four groups ; to receive metronidazole and placebo , cefazolin and placebo , metronidazole and cefazolin , or double placebo .  Patients with generalized peritonitis were excluded for ethical reasons . Treatment was started before operation and continued eight-hourly for twenty-four hours . All patients in the trial were followed up at about two weeks after discharge from hospital and their wounds inspected . Two hundred and seventy-one patients were assessed .  Sepsis rates at the two hospitals were similar . On the untreated controls , 30 % discharged pus from their wounds , and in the groups receiving one drug only , about 20 % . In those receiving both drugs the infection rate was 3 % , a highly significant difference from that in the other three groups
The outcome measures of the studies were : Wound infection , intra abdominal abscess , length of stay in hospital , and mortality .
The overall result is that the use of antibiotics is superior to placebo for preventing wound infection and intraabdominal abscess , with no apparent difference in the nature of the removed appendix .
Studies exclusively on children and studies examining topical application reported results in favour to the above , although the results were not significant .
Antibiotic prophylaxis is effective in the prevention of postoperative complications in appendectomised patients , whether the administration is given pre- , peri- or post-operatively , and could be considered for routine in emergency appendectomies
BACKGROUND Appendicitis is the most common cause of acute abdominal pain requiring surgical intervention .
The cause of appendicitis is unclear and the mechanism of pathogenesis continues to be debated .
Despite improved asepsis and surgical techniques , postoperative complications , such as wound infection and intraabdominal abscess , still account for a significant morbidity .
Several studies implicate that postoperative infections are reduced by administration of antimicrobial regimes .
OBJECTIVES This review evaluated the use of antibiotics compared to placebo or no treatment in patients undergoing appendectomy .
Will these patients benefit from antimicrobial prophylaxis ?