Effect of prophylactic antibiotics in acute nonperforated appendicitis. A prospective, randomized, double-blind clinical study

R. W. Busuttil, R. K. Davidson, M. Fine, R. K. Tompkins

Research output: Contribution to journalArticlepeer-review

55 Scopus citations

Abstract

A prospective, randomized, double-blind clinical study was performed to determine the efficacy of short-term (24 hr) perioperative antibiotics in preventing septic complications after emergency appendectomy for nonperforated appendicitis. The patients were stratified into three clinical arms: Group I (placebo, n = 45), Group II (cefamandole, n = 46) and Group III (cefamandole plus carbenicillin, n = 45). The three groups of patients were similar in regard to age, sex, duration of operation and pathologic classification of the appendix. The overall incidence of infection in the study was 5.1%. The infection rates in Groups II (2.2%) and III (0%) were significantly lower than Group I (placebo) (13.3%), (p<0.05). No difference was observed between cefamandole alone and cefamandole plus carbenicillin. Average postoperative hospital days per patient for each group was: Group I - 3.8 days; Group II - 2.9 days; Group III - 3.1 days. Cost analysis of hospitalization including cost of prophylactic antibiotics revealed a $247.99 per patient saving for Group II versus Group I and $95.53 for Group III versus Group I. Systemic prophylactic antibiotics can successfully reduce septic complications after appendectomy for nonperforated appendicitis, and a single drug (cefamandole) directed at the facultative pathogens is as effective as double drug therapy, which includes specific anaerobic coverage.

Original languageEnglish (US)
Pages (from-to)502-508
Number of pages7
JournalAnnals of surgery
Volume194
Issue number4
DOIs
StatePublished - 1981

ASJC Scopus subject areas

  • Surgery

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