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A double-blind controlled trial of metronidazole suppositories in children undergoing appendicectomy

Insights

Metronidazole suppositories did not prevent post-operative infections in children with appendicitis. This study suggests intra-rectal metronidazole alone is insufficient for effective childhood appendicitis prophylaxis.

Area of Science:

  • Pediatric Surgery
  • Infectious Disease Prevention

Background:

  • Post-operative infections are a concern in pediatric appendicitis.
  • Antibiotic prophylaxis is commonly used to mitigate surgical site infections.

Purpose of the Study:

  • To evaluate the efficacy of intra-rectal metronidazole suppositories as prophylaxis against post-operative infections in children undergoing appendectomy.
  • To determine if short-term metronidazole use reduces wound infection or intra-abdominal sepsis.

Main Methods:

  • A double-blind, placebo-controlled trial was conducted.
  • 133 children (16 months to 15 years) with acute appendicitis received either metronidazole suppositories or placebo for 72 hours post-operatively.

Main Results:

  • No significant difference was observed in the incidence or severity of wound infections between the metronidazole and placebo groups.
  • Similarly, no significant difference was found in the rates of post-operative intra-abdominal sepsis.

Conclusions:

  • Intra-rectal metronidazole, when used as the sole prophylactic agent, is not sufficient for preventing post-operative infections in childhood appendicitis.
  • Further research may be needed to explore alternative or combination prophylactic strategies.

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