Peri-incisional mezlocillin versus rectal-metronidazole for wound infection prophylaxis

One hundred and forty patients who underwent appendicectomy were included in a prospective randomized trial to compare the ability of preoperative rectal metronidazole and peri-incisional mezlocillin to prevent wound infection following appendicectomy. The results show that bactericidal local tissue levels of mezlocillin were uniformly achieved using the peri-incisional technique. The wound infection rate for the metronidazole group was found to be 15.9% and did not significantly differ from the wound infection rate when mezlocillin was used (10.4%). Peri-incisional mezlocillin therefore appears to be a viable prophylactic technique against wound infection following appendicectomy and may offer a cheaper alternative to intravenous intra-operative metronidazole administration in cases when pre-operative metronidazole suppositories have been omitted. The peri-incisional mezlocillin technique is also suitable for routine prophylaxis against wound infection following appendicectomy.