Key result
A single dose of preoperative prophylactic antibiotics resulted in a similar rate of postoperative complications (4.0% vs 6.0%, p=0.455) and a shorter hospital stay (2.5 vs 3.2 days, p<0.001) compared to pre- and postoperative antibiotics in patients undergoing laparoscopic appendectomy for uncomplicated appendicitis.
Why the study?
Does a single dose of preoperative prophylactic antibiotics prevent surgical site infection as effectively as preoperative plus postoperative antibiotics in patients undergoing laparoscopic appendectomy for uncomplicated appendicitis?
Cohort (n=149)
No
Does a single dose of preoperative prophylactic antibiotics prevent surgical site infection as effectively as preoperative plus postoperative antibiotics in patients undergoing laparoscopic appendectomy for uncomplicated appendicitis?
Absolute Event Rate: 4% vs 6%
p-value: p=0.455
A single dose of preoperative prophylactic antibiotics is sufficient for patients undergoing laparoscopic appendectomy for uncomplicated appendicitis, reducing hospital stay without increasing infection risk.
Supports limiting antibiotics to preoperative dose in appendectomy; hypothesis-generating from Level 3 data and requires RCTs before practice change.
Purpose: Research comparing the effectiveness of different doses of antibiotics prior to surgery for preventing infection is sparse. This study examines whether a single dose of preoperative antibiotics suffices to treat uncomplicated appendicitis via laparoscopic appendectomy. Methods: This study retrospectively reviewed the medical records of 149 patients who underwent laparoscopic appendectomy from July 2013 to December 2014 in a single institution. The participants were divided into two groups; group A (n=99) was given a single dose of prophylactic antibiotics before surgery, and group B (n=50) was given both preoperative and postoperative antibiotics. Clinical factors and surgical outcomes were compared between two groups. Results: The mean length of hospital stay for group A (2.5 days) was shorter than for group B (3.2 days) (p0.001). Average operation time was 58.7 minutes for group A, longer than for group B (52.2 minutes, p=0.027). There was no difference in pathologic results and postoperative complications, such as surgical site infection (SSI) between the two groups. In groups A and B, 4.0% of patients had superficial SSIs. One patient (2.0%) in group B had deep/organ SSI.
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Choi et al. (2015) conducted a cohort in Uncomplicated appendicitis (n=149). Single dose of preoperative prophylactic antibiotics vs. Preoperative and postoperative antibiotics was evaluated on Postoperative complications (including surgical site infection) (p=0.455). A single dose of preoperative prophylactic antibiotics resulted in a similar rate of postoperative complications (4.0% vs 6.0%, p=0.455) and a shorter hospital stay (2.5 vs 3.2 days, p<0.001) compared to pre- and postoperative antibiotics in patients undergoing laparoscopic appendectomy for uncomplicated appendicitis.
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