Postoperative Use of Antibiotics in Adults with Non-perforated Appendicitis Subjected to Open Appendectomy
Advances in Surgical Sciences
Volume 5, Issue 3, June 2017, Pages: 41-44
Received: Apr. 2, 2017;
Accepted: Apr. 22, 2017;
Published: May 31, 2017
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Mohamed Ali Mlees, Department of General Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt
Acute appendicitis is the most common cause of acute abdominal pain necessitating appendicectomy. The aim of this study was to determine the role of postoperative antibiotics in non-perforated appendicitis regarding; superficial site infections (SSIs), deep site infections (DSIs), complications and the length of hospital stay. This prospective study was carried out on 112 patients diagnosed as acute appendicitis at the Emergency Hospital, General Surgery Department, Tanta University Hospital from March 2014 to April 2016. The patients classified into two groups: Group 1: patients who received postoperative antibiotics, these included 55 patients and Group 2: patients who did not receive postoperative antibiotics and these included 57 patients. The patients subjected to open appendectomy through a standard Grid-Iron incision. The patients' characteristics, ultrasound findings, antibiotics regimen, operative diagnosis, length of hospital stay, wound infection, complications and histopathological findings were analysed using SPSS V 20. Out of 112 patients, 72 patients were male and 40 patients were female. The patients' age ranged from 18 to 55 years with a mean age of 26 years. There is no significant difference regarding patient's age, sex, medical comorbidities, fever, radiologic findings or operative time between the two groups. Treatment with postoperative antibiotics did not significantly reduce the risk of developing superficial SSIs, DSIs. The patients received postoperative antibiotics were significantly more likely to sustain urinary tract infection (P=0.03) a postoperative diarrhea (P = 0.02), increased risk of Clostridium difficile infection (P =0.01) with higher rates of both readmission (P= 0.08) and reoperation (P = 0.07) with a significantly longer hospital stay (2.6 vs 1.4 days, P = 0.001). The use of postoperative antibiotic treatment for nonperforated appendicitis did not reduce the infectious complications while increasing postoperative morbidity and increase the length of hospital stay.
Mohamed Ali Mlees,
Postoperative Use of Antibiotics in Adults with Non-perforated Appendicitis Subjected to Open Appendectomy, Advances in Surgical Sciences.
Vol. 5, No. 3,
2017, pp. 41-44.
Copyright © 2017 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Vazquez Mohamed AA and Bhat NA: Acute appendicitis dilemma of diagnosis and management. The internet journal of surgery 2010; 23(2), DOI: 10.5580/18e.
Langell JT and Mulvihill SJ: Gastrointestinal perforation and the acute abdomen. Med Clin North Am 2008; 92: 599–625.
Pieper R, Kage L and Nasman P: Acute appendicitis: a clinical study of 1018 cases of emergency appendectomy. Acta Chir Scand 1982; 148: 51–62.
Winsolow RE, Dean RE, Harley JW: Acute nonperforating appendicitis. Arch Surg 1983; 118: 651–654.
Andersson R: Meta-analysis of the clinical and laboratory diagnosis of appendicitis. Br J Surg 2004; 91: 28-37.
Fraser JD, Aguayo P, Leys CM, Keckler SJ, Newland JG, Sharp SW: A complete course of intravenous antibiotics vs. A combination of intravenous and oral antibiotics for perforated appendicitis in children: a prospective randomized trial. Pediatr Surg 2010; 45: 1198-1202.
Ravari H, Jangjoo A, Motamedifar J, Moazzami K: Oral metronidazole as antibiotic prophylaxis for patients with nonperforated appendicitis. Clin Exp Gastroenterol 2011; 4: 273-276.
Coakley BA, Sussman ES, Wolfson TS, Bhagavath AS, Choi JJ, Ranasinghe NE: Postoperative antibiotics correlate with worse outcomes after appendectomy for nonperforated appendicitis. J Am Coll Surg 2011; 213: 778-783.
Malik SA, Rasheed M, Abbasi AS, Iqbal RA, Mian MA: Role of signal dose preoperative antibiotic in acute nonperforated appendicitics. Pak Armed Forces Med J 2013; 63: 114-117.
Department of Health. Hospital episode statistics; England: Financial year 2004–05. Available at www.hesonline.nhs.uk/ Ease/servlet/ ContentServer ? site ID = 1937&categoryID= 202.
Chamisa I: A clinicopathological review of 324 appendices removed for acute appendicitis in Durban, South Africa: a retrospective analysis. Ann R Coll Surg Engl. 2009; 91: 688-692.
Bickel A, Gurevits M, Vamos R, Ivry S, Eitan A: Perioperative hyperoxygenation and wound site infection following surgery for acute appendicitis: a randomized, prospective, controlled trial. Arch Surg. 2011; 146: 464-467.
Mui LM, Ng CS, Wong SK: Optimum duration of prophylactic antibiotics in acute nonperforated appendicitis. Aust N Z J Surg 2005; 75: 425–428.
Le D, RusinW, Hill B, Langell J: Post-operative antibiotic use in nonperforated appendicitis. Am J Surg 2009; 198: 748–752.
Swagata B and Ashwini B. Jajee: Alvarado score: A valuble clinical tool for diagnosis of acute appendicitis- a retrospective study. J Med Allied Sci 2013; 3(2): 63-66.
Subhajeet Dey, Pradip K. Mohanta, Anil K. Baruah, Bikram Kharga, Kincho L. Bhutia, Varun K. Singh : Alvarado Scoring in Acute Appendicitis: A Clinicopathological Correlation. Indian J Surg 2010; 72(4): 290–293.
Busuttil RW, Davidson RK, Fine M, Tompkins RK: Effect of prophylactic antibiotics in acute nonperforated appendicitis: a prospective, double-blind clinical study. Ann Surg 1981; 194: 502–509.
Liberman MA, Greason KL, Frame S, Ragland JJ: Single-dose cefotetan or cefoxitin versus multiple-dose cefoxitin as prophylaxis in patients undergoing appendectomy for acute nonperforated appendicitis. J Am Coll Surg 1995; 180: 77–80.
Dr. P. Venkateshwar and Dr. T. Shalini: Post-Operative Use of Antibiotics in Non-Perforated Appendicitis. IOSR Journal of Dental and Medical Sciences 2015; 14(10): 51-54.
Bader HS and Hamza AS: Wound infection in non-perforated acute appendicitis- single dose preoperative antibiotics vs. prophylactic postoperative antibiotics: does it make any difference? International Journal of Research in Medical Sciences 2016; 4(1): 225-230.