Key result
The addition of post-operative antibiotics to pre-operative antibiotics did not reduce the rate of surgical site infections (10% vs 10%, p=1.000) in patients with non-perforated acute appendicitis.
Why the study?
Does pre-operative and post-operative antibiotic therapy reduce post-operative complications compared to only pre-operative antibiotics in patients with non-perforated acute appendicitis?
RCT (n=60)
Closed envelope technique
No
Does pre-operative and post-operative antibiotic therapy reduce post-operative complications compared to only pre-operative antibiotics in patients with non-perforated acute appendicitis?
Absolute Event Rate: 10% vs 10%
p-value: p=1.000
Pre-operative antibiotics alone are adequate for preventing post-operative complications in non-perforated acute appendicitis, and adding post-operative antibiotics provides no additional benefit.
Supports limiting antibiotics to pre-operative dosing; confirms no added benefit of post-operative therapy for infection prevention in this RCT.
Background: If properly used in appendicitis, antibiotics can reduce the rate of infection by 50%. The use of post-operative antibiotics for preventing infective complications in non-perforated cases is still controversial.Methods: A randomised prospective study was conducted in the Department of Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi with patients who presented acute appendicitis. A minimum number of 30 patients each in group A (pre-operative and post-operative antibiotics) and group B (only pre-operative antibiotics) were evaluated for 18 months, from January 2018 to June 2019.Results: The mean age of group A is 29.9±15.16 years and in group B is 25.97±9.470 years (p value=0.122, insignificant). There was male preponderance. The seroma formation in both the groups was 10.00% and no patients developed intra-abdominal abscess. The incidence of local site oedema was 10% in both the groups A and B and their p value is insignificant. In both the groups A and B, 10% of the people developed pus discharge from the stitch line and the p value is insignificant. In group A, 6.67% of the patients and in group B 10.00% of the patients developed stitch line inflammatory changes and the p value insignificant. In group A, 13.3% and in group B, 10.00% of the patients developed fever and their p value is 1. The mean length of hospital in case 1.23±0.5 days (group A) and is 1.17±0.45 days (group B) (p value=0.508).Conclusions: Hence we can conclude that a well-chosen and adequately-timed pre-operative antibiotics are adequate in preventing post-operative complications and post-operative antibiotics do not affect the same.
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Chowdegowda et al. (2020) conducted an RCT in Non-perforated acute appendicitis (n=60). Pre-operative and post-operative antibiotics vs. Pre-operative antibiotics only was evaluated on Surgical site infections (pus discharge from stitch line) (p=1.000). The addition of post-operative antibiotics to pre-operative antibiotics did not reduce the rate of surgical site infections (10% vs 10%, p=1.000) in patients with non-perforated acute appendicitis.
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