Role of postoperative antibiotics after appendectomy in non-perforated appendicitis.

Abstract

OBJECTIVE: To determine the role of postoperative antibiotics in reducing the surgical site infections (SSIs) after open appendectomy in patients with non-perforated appendicitis (NPA). STUDY DESIGN: Randomized controlled trial. PLACE AND DURATION OF STUDY: The Department of Surgery, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia, from January 2010 to July 2011. METHODOLOGY: Three hundred and seventy seven patients, who underwent appendectomy for NPA and fulfilled the selection criteria, were randomized into two groups. The patients in group A received a single dose of pre- operative antibiotics (cefuroxime sodium and metronidazole), while the group B patients received one more dose of the same antibiotics postoperatively. Patients of both the groups were followed-up for 30 days to assess the postoperative infective complications. RESULTS: Group A had 195, while group B comprised of 182 patients. The groups were comparable in the baseline characteristics. Statistically there was no significant difference in rates of SSIs between both the groups (p = 0.9182). Mean hospital stay was 2.29 ± 0.81 and 2.35 ± 0.48 days for group A and B respectively (p = 0.4403). None of the patients developed intraabdominal collection. CONCLUSION: Single dose of pre-operative antibiotics (cefuroxime and metronidazole) was sufficient in reducing the SSIs after appendectomy for NPA. Postoperative antibiotics did not add an appreciable clinical benefit in these patients.