Related Experiment Video
Updated: Jul 18, 2026
Acupoint Needle-Embedding Combined with Ironing Therapy for Postoperative Pain After Anal Surgery
Published on: June 23, 2023
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
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 outcomes were described according to the nature of the appendix, as either simple appendicitis (including the non-infectious stage) and complicated appendicitis. The efficacy of different antibiotic regimens were not evaluated.
Search Strategy:
We searched The Cochrane Central Register of Controlled Trials (Cochrane Library 2005 issue 1); Pubmed ; EMBASE; and the Cochrane Colorectal Cancer Group Specialised Register (April 2005). In addition, we manually searched the reference lists of the primary identified trials.
Selection Criteria:
We evaluated Randomised Controlled Trials (RCTs) and Controlled Clinical Trials (CCTs) in which any antibiotic regime were compared to placebo in patients suspected of having appendicitis, and undergoing appendectomy. Both studies on children and adults were reviewed. The outcome measures of the studies were: Wound infection, intra abdominal abscess, length of stay in hospital, and mortality.
Data Collection And Analysis:
Eligibility and trial quality were assessed, recorded and cross-checked by two reviewers.
Main Results:
Forty-five studies including 9576 patients were included in this review. 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.
Authors' Conclusions:
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.
Insights
Antibiotic prophylaxis significantly reduces wound infections and intraabdominal abscesses following appendectomy. This review suggests routine use of antibiotics for emergency appendectomies to prevent postoperative complications.
Area of Science:
- Surgical outcomes
- Infectious disease prevention
Background:
- Appendicitis is a common cause of acute abdominal pain requiring surgery.
- Postoperative complications like wound infection and abscesses remain significant despite improved surgical techniques.
- Antimicrobial administration is implicated in reducing postoperative infections.
Purpose of the Study:
- To evaluate the efficacy of antibiotic prophylaxis versus placebo in patients undergoing appendectomy.
- To determine if antimicrobial prophylaxis benefits patients undergoing appendectomy.
- To analyze outcomes based on appendicitis severity (simple vs. complicated).
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs) and controlled clinical trials (CCTs).
- Searched major databases including Cochrane Library, PubMed, and EMBASE.
- Included studies comparing antibiotic regimens to placebo in adult and pediatric appendectomy patients, assessing wound infection, intraabdominal abscess, length of stay, and mortality.
Main Results:
- Forty-five studies with 9576 patients were analyzed.
- Antibiotics demonstrated superiority over placebo in preventing wound infections and intraabdominal abscesses.
- No significant difference was observed in the nature of the removed appendix; topical antibiotic application showed non-significant favorable trends.
Conclusions:
- Antibiotic prophylaxis is effective in preventing postoperative complications after appendectomy.
- Prophylactic antibiotics can be administered pre-, peri-, or post-operatively.
- Routine use of antibiotics in emergency appendectomies is recommended to reduce complications.
Related Concept Videos
01:22Appendicitis-I: Introduction
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...
01:29Appendicitis-II: Diagnostic Studies and Management
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...
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
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...
01:22Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:19Appendicitis