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

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.