Antibiotic protocol for appendicectomy--costs and benefits of single dose therapy

To examine possible savings from the introduction of an antibiotic protocol for one surgical procedure and to define antibiotic charting techniques.

An antibiotic policy for patients undergoing an appendicectomy was instituted in the surgical unit at North Shore Hospital to examine possible savings and to define antibiotic charting techniques. Depending on the macroscopic findings at surgery a third generation cephalosporin was used either as a single dose intraoperatively or for multiple doses postoperatively.

The case notes of a control group of 55 patients were reviewed. This showed an average antibiotic cost per appendicectomy of $69.00 ($52.00) for nongangrenous nonperforated appendices (NGNPA). During the study period 57 patients underwent appendicectomy at an average antibiotic cost of $51.00 ($32.00 for NGNPA). This represented a 26% saving per patient during the study period and a 39% saving for those with NGNPA:

The findings advocate the use of frequently updated guidelines for antibiotic use in surgical procedures. It reaffirms that medical staff must chart precisely as poor charting represents significant waste of expenditure in hospitals.