Is abandoning routine peritoneal cultures during appendectomy justified?

Area of Science:

• Surgical Pathology
• Infectious Diseases
• Clinical Microbiology

Background:

• Appendectomy is a common surgical procedure.
• Peritoneal infections can complicate appendicitis.
• The utility of intraoperative peritoneal fluid cultures is debated.

Purpose of the Study:

• To evaluate the clinical significance of peritoneal fluid cultures during appendectomy.
• To determine if culture results influence patient management or outcomes.

Main Methods:

• Retrospective review of 160 appendectomy cases with peritoneal fluid cultures.
• Analysis of appendix condition, microbial findings, antibiotic use, and outcome data.
• Exclusion of patients with normal appendices or laparoscopic procedures.

Main Results:

• The majority of appendices were perforated (60%) or gangrenous (13%).
• Escherichia coli and Bacteroides were the most common isolates.
• No patient had their antibiotic regimen altered based on culture and sensitivity results.

Conclusions:

• Intraoperative peritoneal fluid cultures during appendectomy provide minimal clinical advantage.
• Empiric antibiotic use and short hospitalizations reduce the impact of culture data.
• Routine peritoneal fluid cultures are not recommended in this setting.