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Prevention of post-appendicectomy sepsis by mezlocillin and metronidazole: a prospective, randomized, double-blind
Abstract:
In a double-blind trial a 6% infection rate resulted from the use of a single peroperative dose of mezlocillin in emergency appendicectomy for non-perforated disease. No advantage was demonstrated by mezlocillin over the 8% infection rate achieved with metronidazole. There was only one anaerobic infection in the mezlocillin group although Bacteroides fragilis had been isolated at operation from all three infected cases and many other uninfected patients. No anaerobic infections were detected in the metronidazole group.
Insights
A study found mezlocillin and metronidazole had similar infection rates for appendectomy. Mezlocillin showed no advantage over metronidazole, despite Bacteroides fragilis presence. No anaerobic infections occurred with metronidazole.
Area of Science:
- Infectious Diseases
- Surgical Infections
- Pharmacology
Background:
- Appendectomy is a common surgical procedure.
- Surgical site infections (SSIs) are a significant complication.
- Antibiotic prophylaxis is standard for appendectomy.
Purpose of the Study:
- To compare the efficacy of mezlocillin and metronidazole as single-dose preoperative antibiotic prophylaxis in emergency appendectomy for non-perforated appendicitis.
- To evaluate the impact of these antibiotics on overall and anaerobic infection rates.
Main Methods:
- A double-blind, randomized controlled trial was conducted.
- Patients received either a single preoperative dose of mezlocillin or metronidazole.
- Infection rates, including anaerobic infections, were monitored postoperatively.
Main Results:
- The mezlocillin group had a 6% infection rate.
- The metronidazole group had an 8% infection rate.
- Mezlocillin demonstrated no significant advantage over metronidazole in reducing overall infection rates. Only one anaerobic infection occurred in the mezlocillin group, while none were detected in the metronidazole group, despite isolation of Bacteroides fragilis in both groups.
Conclusions:
- Single-dose preoperative mezlocillin is not superior to metronidazole for preventing infections in emergency appendectomy for non-perforated disease.
- Metronidazole may be effective in preventing anaerobic infections in this surgical context.