Related Experiment Videos

Antibiotics versus placebo for prevention of postoperative infection after appendicectomy

B R Andersen1, F L Kallehave, H K Andersen

  • 1Department of Surgical Gastroenterology K, H:S Bispebjerg Hospital, 23 Bispebjerg Bakke, Copenhagen NV, Denmark, DK 2400. cccg@cccg.dk

The Cochrane Database of Systematic Reviews
|June 19, 2001
PubMed
Abstract

Insights

Antibiotic prophylaxis significantly reduces postoperative complications like wound infections and intraabdominal abscesses in patients undergoing appendectomy. This treatment is effective and should be considered for routine use in emergency appendectomies.

Area of Science:

  • Surgery
  • Infectious Diseases
  • Clinical Trials

Background:

  • Appendicitis is a common cause of acute abdominal pain requiring surgery.
  • Postoperative complications, including wound infection and intraabdominal abscess, remain significant despite advances in surgical techniques.
  • Antimicrobial administration is suggested to reduce postoperative infections.

Purpose of the Study:

  • To compare the efficacy of antibiotics versus placebo or no treatment in preventing complications after appendectomy.
  • To determine if antimicrobial prophylaxis benefits patients undergoing appendectomy for simple or complicated appendicitis.

Main Methods:

  • Systematic review and meta-analysis of Randomized Controlled Trials (RCTs) and Controlled Clinical Trials (CCTs).
  • Searched major databases including Cochrane Library, Medline, and Embase.
  • Included studies comparing antibiotic regimens to placebo in adult and pediatric patients undergoing appendectomy, assessing outcomes like wound infection, intraabdominal abscess, hospital stay, and mortality.

Main Results:

  • Analysis of 44 studies involving 9298 patients.
  • Antibiotics demonstrated superiority over placebo in reducing wound infections and intraabdominal abscesses.
  • No significant difference was observed based on the nature of the appendix; however, studies in children and those using topical antibiotics showed favorable trends.

Conclusions:

  • Antibiotic prophylaxis is effective in preventing postoperative complications following appendectomy.
  • Prophylactic antibiotics can be administered pre-, peri-, and post-operatively.
  • Routine use of antibiotic prophylaxis in emergency appendectomies is recommended.

Related Concept Videos

Appendicitis-II: Diagnostic Studies and Management01:29

Appendicitis-II: Diagnostic Studies and Management

Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Appendicitis-I: Introduction01:22

Appendicitis-I: Introduction

The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Appendicitis01:19

Appendicitis

Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...