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[Effectiveness of rectal metromidazole in acute infantile appendicitis]
Insights
Rectal metronidazole suppositories effectively prevent wound infections in children undergoing appendicitis surgery. This method achieved optimal drug levels with no side effects, ensuring satisfactory patient outcomes.
Area of Science:
- Pediatric Surgery
- Infectious Disease Pharmacology
Context:
- Appendicitis surgery in children carries a risk of wound infection.
- Prophylactic antibiotics are crucial for preventing surgical site infections.
Purpose:
- To evaluate the efficacy of rectal metronidazole for preventing wound infections in pediatric appendicitis surgery.
- To determine serum concentrations and bioavailability of rectally administered metronidazole.
Summary:
- Thirty-two children received prophylactic metronidazole suppositories before appendicitis surgery.
- Serum drug concentrations reached minimal bactericidal levels pre-anesthesia.
- Optimal bioavailability and no adverse effects were observed with rectal administration.
Impact:
- Rectal metronidazole proved effective in preventing wound infections and sepsis.
- This administration route offers a safe and satisfactory prophylactic option.
- Supports the use of rectal metronidazole in pediatric appendicitis prophylaxis.
Abstract:
Thirty two consecutive children who underwent surgery for suspected acute appendicitis, were treated with prophylactic metronidazole suppositories. A serum sample was taken at surgery to determine the serum concentration of the drug. After a preoperative dose of 15-20 mg/kg the minimal bactericidal concentration was achieved in almost all cases at the time of anesthetic induction. This drug showed an optimal biodisponibility when used rectally and no side-effects was noted. Neither a wound-infection, nor a wound-sepsis was reported and a satisfactory outcome was registered. We conclude that rectal dosing with metronidazole is effective for prophylactic wound infection in acute appendicitis.