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[Prevention of surgical wound infections after appendectomy: intravenous versus rectal metronidazole]
1Departamento de Cirugía, Facultad de Medicina, Universidad de Concepción, Chile.
Aim:
To compare the efficacy of rectal and intravenous metronidazole in the prevention of anaerobic wound infections after appendicectomy.
Patients And Methods:
One hundred patients subjected to appendicectomy were randomly assigned to receive, 2 hours before operation, gentamycin 80 mg i.v. and metronidazole 1 g i.v. or the same amount of gentamycin and 1 g of metronidazole as a suppository. Surgical wounds were observed for infections until the tenth day of the postoperative period.
Results:
Seven of 45 patients receiving intravenous metronidazole and six of 44 receiving the drug as suppositories had wound infection. The frequency of infections was higher among patients with gangrenous or perforated appendices. They were detected at the fifth postoperative day in 8 patients and the most frequently isolated bacteria were E coli and S aureus.
Conclusions:
Rectal metronidazole is equally effective than intravenous metronidazole in the prevention of would infections after appendicectomy.
Insights
Rectal metronidazole is as effective as intravenous metronidazole for preventing anaerobic wound infections after appendicectomy. This study compared both administration routes in patients undergoing appendicectomy.
Area of Science:
- Infectious Diseases
- Surgical Infections
- Pharmacology
Background:
- Appendicectomy is a common surgical procedure.
- Anaerobic wound infections can complicate appendicectomy outcomes.
- Metronidazole is a key antibiotic for anaerobic infections.
Purpose of the Study:
- To compare the efficacy of rectal versus intravenous metronidazole.
- To evaluate the prevention of anaerobic wound infections post-appendicectomy.
Main Methods:
- 100 patients undergoing appendicectomy were randomized.
- Groups received intravenous or rectal metronidazole (1g) pre-operatively.
- Gentamycin was co-administered intravenously to both groups.
- Wound infections were monitored for 10 days post-surgery.
Main Results:
- Wound infection rates were similar: 7/45 (intravenous) vs. 6/44 (rectal).
- Higher infection rates observed in patients with gangrenous or perforated appendices.
- E. coli and S. aureus were the most common bacteria isolated.
Conclusions:
- Rectal metronidazole is a viable and effective alternative to intravenous administration.
- Both routes demonstrate comparable efficacy in preventing anaerobic wound infections after appendicectomy.