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Related Experiment Videos

Prophylactic metronidazole in appendicectomy: a controlled trial

T Bates, V L Touquet, M K Tutton

    The British Journal of Surgery
    |August 1, 1980
    PubMed
    Summary

    Prophylactic metronidazole reduced early hospital wound infections after appendicectomy but did not significantly alter overall infection rates. Patients receiving metronidazole had shorter hospital stays, suggesting potential benefits despite limitations in preventing late infections.

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    Area of Science:

    • Surgical Infection Prevention
    • Pharmacology
    • Clinical Microbiology

    Background:

    • Appendicectomy is a common surgical procedure with a risk of postoperative wound infections.
    • Metronidazole is an antibiotic often used for anaerobic infections, but its efficacy in preventing surgical site infections in appendicitis requires evaluation.

    Purpose of the Study:

    • To compare the efficacy of prophylactic metronidazole with no treatment in preventing wound infections following appendicectomy.
    • To assess the impact of prophylactic metronidazole on postoperative hospital stay and the types of infections occurring.

    Main Methods:

    • A randomized controlled trial involving patients undergoing appendicectomy.
    • Intervention group received a 1-g metronidazole suppository and oral metronidazole for 7 days.

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  • Control group received no prophylactic antibiotic treatment.

    • Main Results:

    • Fewer hospital wound infections occurred in the metronidazole group (4/87) compared to the no-treatment group (11/83), P < 0.05.
    • Overall infection rates were not significantly different, with many infections occurring post-discharge.
    • Postoperative hospital stay was significantly shorter in the metronidazole group (4.8 days) versus the control group (5.8 days), P < 0.01.
    • Only one anaerobic infection was observed in the metronidazole group; late infections were not prevented.

    Conclusions:

    • Prophylactic metronidazole may reduce early, in-hospital wound infections after appendicectomy and shorten hospital stays.
    • Metronidazole alone may not be sufficient to prevent all surgical site infections in appendicitis, particularly late-onset or those involving aerobic organisms.
    • Further research into antibiotics effective against both aerobic and anaerobic bacteria may be warranted for appendicitis prophylaxis.