Antibiotics prophylaxis in non-perforated appendicitis : a prospective study

Abstract EN

Background : The haphazard use of antibiotics in some centers is increasing and causing more harmful complications than its benefit.

Objective : To study the role of antibiotics prophylaxis in low-risk non-perforated acute appendicitis.

Methods : This study was done at Al-Kindy Teaching hospital in the period between Jan.

1999- Feb.

2000.

100 cases of acute appendicitis selected prospectively to be involved in a study including the use of prophylactic antibiotic therapy versus none.

Criteria for selection were ; age range between 13-30 years, no additional preoperative risk factors (diabetic, pregnant ladies, patients on steroid or anti-cancer therapy were all excluded), proper aseptic operative technique performed.

Patients were divided into two groups, group A (n = 53) were given antibiotic prophylaxis per-operatively (1gm of cefizox I.

V), while group B (n = 47) were given no antibiotics.

Intraperitoneal cultures were taken prior to antibiotic therapy.

All excised appendices were sent for histopathological examination.

Follow up was up to 4 weeks.

Results : The study showed no statistically demonstrable difference among patients in group A (antibiotic group) and group B (control) regarding duration of hospital stay, incidence of wound infection, incidence of delayed postoperative complications.

Conclusions : Antibiotic prophylaxis can be safely omitted in low-risk patients with non-perforated acute appendicitis, careful aseptic technique is mandatory.

Cultures of peritoneal cavity are not necessary, saving efforts and financial resources.