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Post-operative antibiotic use in nonperforated appendicitis
Dinhkim Le1, Wendy Rusin, Britani Hill
1Department of Surgery, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
American Journal of Surgery
|December 9, 2009
Summary
Postoperative antibiotics after appendectomy for nonperforated appendicitis do not reduce surgical site infections (SSIs). This study found no significant difference in SSIs or other complications between patients who received postoperative antibiotics and those who did not.
Area of Science:
- Surgical infection prevention
- Antibiotic stewardship
- Gastrointestinal surgery outcomes
Background:
- Preoperative antibiotics reduce surgical site infections (SSIs) in appendectomy for acute appendicitis.
- The efficacy of postoperative antibiotic use in these patients is not well-established.
Purpose of the Study:
- To evaluate the impact of postoperative antibiotics on SSIs and other complications following appendectomy for nonperforated appendicitis.
Main Methods:
- Retrospective review of 763 appendectomy cases for nonperforated appendicitis (1997-2007).
- Analysis of patient outcomes, including SSIs, urinary tract infections, diarrhea, and Clostridium difficile infections.
- Comparison between patients who received postoperative antibiotics and those who did not.
Main Results:
- No significant difference in overall SSIs (10% vs 9%, P = .64) between groups receiving or not receiving postoperative antibiotics.
- Comparable rates for superficial, deep, and organ space SSIs across both groups.
- Similar rates of urinary tract infections and diarrhea between patients who did and did not receive postoperative antibiotics.
Conclusions:
- Postoperative antibiotic administration does not appear to decrease the rate of SSIs in patients undergoing appendectomy for nonperforated appendicitis.
- Routine use of postoperative antibiotics may increase healthcare costs without providing additional clinical benefit.
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