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 ?
Gangrenous and perforated appendicitis with peritonitis: treatment and bacteriology.
A comparison of single-agent antimicrobial therapy in the treatment of patients with perforated or gangrenous appendicitis and peritonitis was performed in a double-blind , r and omized , prospect i ve trial . Pathologic documentation of advanced appendicitis and positive intraoperative specimen cultures were required for inclusion in the study . Ceftizoxime ( 2 gm every 12 hours ) and cefoxitin ( 2 gm every six hours ) were compared . There were no significant differences between the treatment groups . Ninety-seven percent of patients treated with ceftizoxime and 89 % of those treated with cefoxitin were cured or improved ; there was no mortality in either group . By the use of optimal sampling , transport , and culture techniques , the number and diversity of bacteria recovered from these patients with advanced appendicitis were found to be much larger than previously suspected . Peritoneal fluid , abscess contents ( if present ) , and appendiceal tissue ( obtained so as to exclude the lumen ) were cultured from all patients . An average number of 3.1 aerobic or facultative bacteria species and 8.5 anaerobic species were isolated from each specimen . Twenty-eight different genera and more than 55 species were encountered , including a previously undescribed fastidious gram-negative anaerobic bacillus . Bacteroides fragilis group and Escherichia coli were isolated from almost all specimens , and within the B fragilis group , eight species were represented . The recovery of such an unexpectedly large and diverse flora may be the reason for the therapeutic failures in these patients . We conclude that single-agent antimicrobial therapy in patients with advanced appendicitis and peritonitis is both safe and effective , and , with ceftizoxime , can be accomplished by a twice-daily dosing regimen
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 ?