Background & Objectives: Empirical antibiotics are being administered pre and post-operatively in acute appendicitis. The routine, widespread indiscriminate and prolonged antibiotic course has become an ailment in itself, as it gives rise to resistant strains of organisms. The present study was conducted in a tertiary care center, to formulate a plan for the rational use of antibiotics after appendectomy, so effective treatment could be given to those at high risk of developing septic complications.

Methods: This is a prospective study done in General Surgery department at a Tertiary Care Centre from September 2014 to December 2016. 360 cases of appendectomy were studied in this study. Out of which 72 cases belonged to interval appendectomy group, 168 acute appendicitis and 120 cases belonged to the group appendicitis with complications like perforation and gangrene. Patients undergoing interval appendectomy received single dose of antibiotics. Patients having acute appendicitis (uncomplicated) received three doses of antibiotic prophylaxis and patients having complications like perforation and gangrene received antibiotic for 5 days. Post-operative complications like wound infection, wound gaping, etc. were recorded.

Results: The study included 360 patients out of which there were 169 males (65%) and 91 (35%) females with a M: F ratio of 1.86:1. The incidence of wound infection in interval appendectomy, uncomplicated and complicated appendicitis was found to be 6.94%, 8.93% and 13.33% respectively. Incidence of post-operative complications was found to be highest in cases with complicated appendicitis (16.7%) followed by uncomplicated appendicitis (12.50%). Least postoperative complications were seen in patients who had undergone interval appendectomy (6.95%). The difference in white blood cell count, timing of prophylactic antibiotic before surgery, operation time and duration of hospital stay were found to be statistically significantly different in these groups. Statistical analysis was done using SSPE 17.0 software. P value less than 0.05 was taken as statistically significant.

Conclusion: In patients with appendicitis the rational use of antibiotics will reduce the incidence of antibiotic resistance and treatment cost without increasing post-operative complications.

Keywords: Acute appendicitis, appendectomy, perforated appendix, Antibiotics resistance.

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Dr Ritesh S. Satardey

107, Janki Nagar, Nagpur-34, India