A randomized prospective study of cefoxitin versus piperacillin in appendicectomy

Area of Science:

• Surgical Infection Prevention
• Clinical Microbiology
• Pharmacology

Background:

• Appendicitis is a common surgical emergency.
• Wound infection is a potential complication of appendectomy.
• Antibiotic prophylaxis is standard practice to reduce surgical site infections.

Purpose of the Study:

• To compare the efficacy of cefoxitin versus piperacillin as single-dose prophylactic antibiotics in patients undergoing surgery for non-perforated appendicitis.
• To evaluate the incidence of wound infections in both treatment groups.
• To assess the impact of wound infection on hospital stay.

Main Methods:

• A randomized prospective study involving 250 adult patients with non-perforated appendicitis.
• Patients received either a single intravenous dose of 2g cefoxitin (124 patients) or 2g piperacillin (126 patients) immediately before surgery.
• Wound infection rates and causative organisms were monitored.

Main Results:

• Wound infection occurred in 2.4% of the cefoxitin group and 4% of the piperacillin group, with no statistically significant difference.
• Escherichia coli was the most common infecting organism (5 out of 8 cases).
• Patients with wound infections had a significantly longer mean hospital stay (15 days) compared to uninfected patients (6 days).

Conclusions:

• Both cefoxitin and piperacillin are similarly effective as single-dose prophylactic antibiotics for non-perforated appendicitis.
• Prophylactic antibiotics significantly reduce the risk of wound infections and associated prolonged hospital stays.
• Effective antibiotic prophylaxis is crucial in managing appendicitis patients to improve outcomes.