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Timing of antibiotic treatment in non-perforated gangrenous appendicitis
P Almqvist1, L Leandoer, A Törnqvist
1Department of Surgery, Lund University, Malmö General Hospital, Sweden.
Objective:
To assess whether antibiotic treatment with cefuroxime and tinidazole started during the operation was as effective as treatment started before operation in patients with gangrenous non-perforated appendicitis.
Design:
Prospective randomised study.
Setting:
University hospital, Sweden.
Subjects:
114 patients with gangrenous, non-perforated appendicitis who had had antibiotics started before operation and 120 whose treatment was started during operation out of a total of 575 who presented with a presumptive diagnosis of appendicitis.
Main Outcome Measures:
Morbidity and mortality.
Results:
There were no deaths, and the rates of infective complications were 1/114 (0.9%) and 3/120 (3%), respectively. The median hospital stay was four days in both groups.
Conclusion:
Antibiotic treatment started during the operation is not significantly worse at preventing infective complications in non-perforated, gangrenous appendicitis than treatment started before the operation.