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Antibiotic Treatment Has No Influence on Anal Fistula Formation and Recurrent Perianal Abscess After Incision and

Ahmad Nasasra1, Yehuda Hershkovitz1, Itamar Ashkenazi2

  • 1Division of Surgery, Shamir Medical Center, Affiliated to the Tel Aviv University, Zerifin, Israel.

Diseases of the Colon and Rectum
|May 3, 2024
PubMed
Abstract

Insights

Antibiotic treatment did not influence the development of anal fistula or recurrent perianal abscess after perianal abscess incision and drainage. This study found no significant difference between antibiotic and no-antibiotic groups in patient outcomes.

Area of Science:

  • Colorectal surgery
  • Infectious disease management

Background:

  • Anal fistula commonly develops after perianal abscess incision and drainage.
  • Antibiotics have been theorized to reduce fistula formation post-surgery.
  • This study investigates the actual impact of antibiotic therapy on fistula development.

Purpose of the Study:

  • To test the hypothesis that antibiotic treatment does not affect anal fistula development after perianal abscess surgery.
  • To evaluate the effect of antibiotics on recurrent perianal abscess formation.

Main Methods:

  • A single-blinded, randomized prospective study involving patients with primary cryptogenic abscesses.
  • Patients were divided into two groups: one receiving amoxicillin/clavulanic acid for 7 days post-surgery, and a control group receiving no antibiotics.
  • Outcomes, including anal fistula formation and recurrent perianal abscess, were assessed at multiple follow-up points up to one year.

Main Results:

  • A total of 98 patients completed the study with no significant differences in baseline characteristics between groups.
  • Anal fistula developed in 16.3% of the antibiotic group versus 10.2% of the control group (p=0.67).
  • Recurrent perianal abscess occurred in 9.2% of patients, with no significant difference between the treatment and control groups (p=0.73).

Conclusions:

  • Antibiotic therapy, specifically amoxicillin/clavulanic acid, does not influence the formation of anal fistula after perianal abscess incision and drainage.
  • The study also found no significant impact of antibiotic use on the recurrence of perianal abscesses.
  • Limitations include a relatively small sample size treated at a single center.

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