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 place of antibiotics in the prevention of post-appendicectomy sepsis: a prospective study of 400 cases.
Post-appendicectomy sepsis still causes considerable morbidity and prolongs hospital stay . A large amount of recent work has gone into attempts to reduce such problems using various topical and systemic agents in differing regimes , with wide variation in their results . The aim of our study was to examine further the effectiveness of those different lines of prophylaxis against placebo in reducing post-appendicectomy sepsis . It is a comparative study of 400 cases of uncomplicated appendicitis operated upon by three senior Surgeons . The cases were allocated r and omly in equal number to four groups according to the prophylactic antibiotic regime used : ( a ) Placebo ; ( b ) Metronidazole alone ; ( c ) Metronidazole and cefazolin ; ( d ) Metronidazole and tobramycin . Antibiotics were given preoperatively with premedication and continued postoperatively for three days . The patients were checked for signs of sepsis during hospital stay and weekly up to a minimum of four weeks after discharge . They were also compared as far as their hospital stay is concerned . The conclusion of this study is that a combination of an antibiotic aim ed at aerobes ( cefazolin or tobramycin ) with another aim ing at anaerobes ( metronidazole ) is the best prophylactic regime against post-appendicectomy sepsis
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 ?