Key result
Post-operative oral antibiotics for five days did not significantly reduce the frequency of surgical site infection compared to placebo following appendectomy for non-perforated appendicitis (12% vs 16%, p=0.2482).
Why the study?
Do post-operative oral antibiotics reduce the frequency of surgical site infection in patients undergoing appendectomy for non-perforated appendicitis?
RCT (n=150)
Placebo-controlled
Lottery method
No
Do post-operative oral antibiotics reduce the frequency of surgical site infection in patients undergoing appendectomy for non-perforated appendicitis?
Absolute Event Rate: 12% vs 16%
p-value: p=0.2482
Post-operative oral antibiotics do not significantly reduce surgical site infections compared to placebo after non-perforated appendectomy.
Supports omitting routine post-operative oral antibiotics after non-perforated appendectomy; reinforces lack of benefit in prior RCTs.
Background: Acute appendicitis is most frequent cause of acute abdomen in younger population, and surgical site infection (SSI) is commonest complication of appendectomy. The objective of this trial was to compare the efficacy of post-operative oral antibiotics versus placebo in reducing the frequency of surgical site infection (SSI) following appendectomy for non-perforated appendicitis in population of South Waziristan Agency, Pakistan.Materials Methods: The randomized placebo trial was conducted at Agency Headquarter Hospital, Wana, South Waziristan, Pakistan from October 1, 2016 to November 18, 2018. One hundred fifty (150) patients were randomly allocated into two groups, 75 in experimental group, to whom antibiotics were given and 75 in placebo group, to whom antibiotics were not given. Age groups and presence of SSI were two variables, being on nominal scale, were described by count and percentage with CI at 80%CL. McNemar chi-square test was applied to test the hypothesis to see the significance of difference between the experimental and placebo groups in terms of frequency of SSI at alpha .05.Results: SSI was present in nine (12%, 80%CI 7.19-16.80%) out of 75 cases in experimental group and in 12 (16%, 80%CI 10.57-21.42%) out of 75 cases in placebo group. McNemar chi-square test showed no significant difference between the experimental and placebo groups in terms of frequency of SSI (p=.2482).Conclusion: The results are comparable for post-operative oral antibiotics versus placebo in reducing the frequency of surgical site infection (SSI) following appendectomy for non-perforated appendicitis in population of South Waziristan Agency, Pakistan.
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Alam et al. (2021) conducted an RCT in Non-perforated appendicitis (n=150). Post-operative oral antibiotics (co-amoxiclav) vs. Placebo (multivitamins) was evaluated on Frequency of surgical site infection (SSI) (p=0.2482). Post-operative oral antibiotics for five days did not significantly reduce the frequency of surgical site infection compared to placebo following appendectomy for non-perforated appendicitis (12% vs 16%, p=0.2482).
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