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 ?
Prophylactic metronidazole in appendectomy: a double-blind controlled trial.
Ninety-eight patients with suspected nonperforated acute appendicitis have to date been entered into a continuing , prospect i ve , blinded r and omized trial to determine the role of prophylactic metronidazole in postoperative wound infection . Twenty-six patients were excluded for the following reasons : diagnosis other than acute appendicitis ( 16 ) , perforation of the appendix ( 8) , administration of other antibiotics ( 1 ) , and refusal to enter study ( 1 ) . Seventy-two patients , 47 men and 25 women , with a mean age of 27.5 years ( range 15 to 60 years ) , underwent appendectomy and were studied . Thirty patients received 1 gm intravenous metronidazole preoperatively and five intravenous doses of 500 mg metronidazole postoperatively . Forty-two patients received placebo only . Cultures of the appendiceal stump grew aerobic cultures in 45 ( 62 % ) and anaerobic organisms in 29 ( 40 % ) : Escherichia coli and Bacteroides fragilis , respectively . Six of the 72 patients ( 8.2 % ) developed postoperative wound infections : four of 42 ( 9.5 % ) who received placebo and two of 30 ( 6.6 % ) who received metronidazole ( P = 0.54 by Fisher exact test ) . No toxicity from metronidazole  was observed . The postoperative wound infection rate is insufficient to demonstrate the efficacy of metronidazole for prophylaxis in nonperforated acute appendicitis , although there appears to be a tendency of to assume its efficacy in this regard
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 ?