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Effect of metronidazole and ampicillin on patients with gangrenous or perforated appendicitis. A comparative study
Abstract:
A study comparing the effectiveness of metronidazole and ampicillin in preventing wound infection in gangrenous or perforated appendicitis without general peritonitis was performed. Metronidazole was given as suppository immediately after the operation (1 g) and the administration continued for 10 days. Initially, one suppository was given every 8 h for one or two days, thereafter one tablet (400 mg) every 8 h until 10 days after the operation. In the ampicillin group, ampicillin (4.0-6.0 g) was deposited intraperitoneally during surgery, followed by 1.0 g ampicillin every 6 h, first intravenously (or intramuscularly) for one or two days and thereafter as tablets. Of the 50 patients initially present in the study, 7 were excluded, 22 received ampicillin and 21 metronidazole. In the first group, 8 patients had perforated, and 14 patients gangrenous appendicitis. In the metronidazole group, the corresponding figures were 11 and 10. The mean hospitalization period after operation was 6.8 days for both groups. In the metronidazole group, wound infection was not observed. In the ampicillin group, 2 patients (9.1%) had wound infections.
Insights
Metronidazole effectively prevented wound infections in appendicitis patients, showing superior results compared to ampicillin. This study highlights metronidazole as a key treatment for preventing surgical site infections in appendicitis cases.
Area of Science:
- Surgical Infectious Diseases
- Pharmacology
- Gastrointestinal Surgery
Background:
- Appendicitis, particularly gangrenous or perforated types, carries a risk of postoperative wound infection.
- Antibiotic prophylaxis is crucial in managing appendicitis to reduce infectious complications.
- Comparing the efficacy of different antibiotic regimens is essential for optimizing patient outcomes.
Purpose of the Study:
- To compare the effectiveness of metronidazole versus ampicillin in preventing wound infections after surgery for gangrenous or perforated appendicitis.
- To evaluate the incidence of wound infections in patients treated with either metronidazole or ampicillin.
- To assess the safety and efficacy of different antibiotic administration routes and durations.
Main Methods:
- A comparative study involving patients with gangrenous or perforated appendicitis without general peritonitis.
- Patients received either metronidazole (suppository/tablet) or ampicillin (intraperitoneal/intravenous/oral) post-operation.
- Wound infection rates and hospitalization periods were recorded and compared between the two groups.
Main Results:
- No wound infections were observed in the metronidazole group (21 patients).
- Two patients (9.1%) in the ampicillin group (22 patients) developed wound infections.
- The mean postoperative hospitalization period was similar for both groups (6.8 days).
Conclusions:
- Metronidazole demonstrated complete effectiveness in preventing wound infections in this cohort.
- Ampicillin prophylaxis resulted in a 9.1% wound infection rate in patients with complicated appendicitis.
- Metronidazole appears to be a highly effective agent for preventing surgical site infections in appendicitis cases.