Antibiotic Therapy Following Acute Supurative Appendectomy: Is it Necessary?

Acute appendicitis is one of the most common acute surgical interventions. The base of treatment is surgery but, preoperative and postoperative steps have important role in its outcome. The usefulness of administration of prophylactic antibiotic in acute appendicitis and antibiotic treatment in gangrenous appendicitis and peritonitis has been proved but antibiotic treatment in the first 24h after appendectomy in supurative appendicitis is not clearly defined. Therefore, the aim in this study we try address this problem. In this prospective and blind clinical trial study which was carried out over three years (1379 to 1382) in three educational hospitals affiliated to Ahwaz Jundishapur University of Medical Sciences, on all the cases of supurative appendicitis. In this study 200 patient were divided in two equal groups. The first group was treated with prophylactic antibiotic (cefazolin and metronidazole) in addition to cefazolin and metronidazol 24 h after surgery while the second group only received prophylactic antibiotic treatment. Both groups of patients were followed up for two months and compared for wound infection, post –operative fever, abdominal and pelvic abscess, wound dehiscence and duration of hospitalization. The mean age in was 18.5 y (range 15-40 y) and there was male (56 %). The results showed that there were no significant differences between the selected groups in relation to the rate of wound infection, post-operative fever, and duration of hospitalization which, in group 1 and 2, respectively, were 4 and 6 %, 6 and 8 % and 2.6 and 2.8 days. In addition, there were no cases of abdominal and pelvic abscess and wound dehiscence in either group of patients. The findings from this study show that post-operative antibiotic treatment has no clinical value in reducing the incidence of wound infection, post operative fever, and on the duration of hospitalization. In patients who undergo appendectomy for acute supurative appendicitis.