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Should prophylactic antibiotics be given perioperatively in acute appendicitis without perforation?
Canadian Journal of Surgery. Journal Canadien De Chirurgie
|September 1, 1982
Summary
Prophylactic antibiotics are questioned for all acute appendicitis cases without perforation. Wound infection rates are low, suggesting reserved antibiotic use for severe cases, not routine administration.
Area of Science:
- Surgery
- Infectious Diseases
- Clinical Trials
Background:
- Wound infection is a potential complication following appendectomy.
- The efficacy of prophylactic antibiotics in reducing wound infections in uncomplicated acute appendicitis is debated.
Purpose of the Study:
- To evaluate the necessity of routine perioperative prophylactic antibiotics in patients with acute appendicitis without perforation.
- To determine if antibiotic administration significantly reduces the incidence of surgical site infections.
Main Methods:
- A retrospective analysis of 82 patients was conducted.
- A prospective, double-blind, placebo-controlled clinical trial involving 42 patients was performed, comparing cefamandole with a placebo.
Main Results:
- The retrospective study showed a low wound infection rate (4.8%).
- In the prospective trial, 1 out of 21 patients receiving placebo developed a wound infection, while none of the 21 patients receiving cefamandole did.
- The incidence of wound infection in patients not receiving antibiotics was comparable to those receiving them in the retrospective analysis.
Conclusions:
- The incidence of wound infection in acute appendicitis without perforation is low.
- Routine perioperative antibiotic administration may not be warranted for all cases.
- Antibiotic use should be considered for patients with suspected more severe disease.