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Imipenem therapy for perforated and gangrenous appendicitis
Surgery, Gynecology & Obstetrics
|January 1, 1986
Summary
Imipenem-cilastatin therapy for appendicitis with perforation or gangrene showed effectiveness, with fewer fever and hospitalization days compared to clindamycin-gentamicin. This broad-spectrum antibiotic is a viable adjunct to surgery for complicated appendicitis.
Area of Science:
- Infectious Diseases
- Surgical Infections
- Pharmacology
Background:
- Appendicitis, particularly when perforated or gangrenous, presents a significant surgical challenge.
- Effective antimicrobial therapy is crucial for managing complex appendicitis cases and preventing complications.
Purpose of the Study:
- To evaluate the efficacy and safety of imipenem-cilastatin compared to clindamycin-gentamicin in treating perforated or gangrenous appendicitis.
Main Methods:
- A matched patient control study comparing 33 patients treated with imipenem-cilastatin to 66 controls on clindamycin-gentamicin.
- Patients were matched for age and surgical pathology.
- Microbiological analysis of pathogens, including anaerobes and Pseudomonas, was performed.
Main Results:
- Imipenem-cilastatin demonstrated comparable efficacy to clindamycin-gentamicin, with only one failure in the imipenem group.
- Imipenem-treated patients experienced significantly fewer days of fever and hospitalization.
- Most isolated pathogens, including Bacteroides fragilis group and Pseudomonas, were susceptible to imipenem.
Conclusions:
- Imipenem-cilastatin is an effective antimicrobial agent as an adjunct to surgical treatment for complicated appendicitis.
- It offers potential benefits in reducing fever and hospitalization duration.
- The drug is effective against common pathogens, including challenging organisms like Bacteroides fragilis and Pseudomonas.