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Category: Volume 08 Issue 11 November 2020
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Title: Non beneficence of postoperative antibiotics in uncomplicated appendicitis- A single centre retrospective study

Authors: Nada Ayoub, Yegor Tryliskyy, Chukwuemeka Anele, Michael Elliot, Mirza K Baig

 DOI: https://dx.doi.org/10.18535/jmscr/v8i11.97

Abstract

Introduction: Several studies have shown benefit from use of preoperative antibiotics in reducing postoperative infection after appendectomy as well as efficacy of postoperative antibiotics in complicated appendicitis (defined as perforated appendix or presence of pus in peritoneum). While for uncomplicated appendicitis, several studies showed no benefit from antibiotics postoperatively but there are no clear NICE guidelines in UK till now and so surgeons have different practice based on their preferences.

Aim: The aim of this study is to find whether administration of postoperative antibiotics in uncomplicated appendicitis was superior to non-administration or not regarding 30-day postoperative wound infection or collection

Methods: This study included patients who had appendectomy for uncomplicated appendicitis in Worthing hospital from 1st July 2019 till 30th June 2020. The end point was 30-day follow up postoperatively for wound infection or collection.

Results: 90 patients were admitted with uncomplicated appendicitis with age 6-80 years (mean of 31.3). 46 patients (51%) did not receive postoperative antibiotics (group A) and 44 (49%) received postoperative antibiotics (group B) with a variable practice from one dose to 8-day course. postoperatively, only 1 patient (2.1%) in group A developed wound infection requiring drainage while none in group B developed complications (p-value=1).

Conclusion: Administration of postoperative antibiotics in uncomplicated appendicitis showed no superiority over non-administration. in addition, they add extra cost on NHS. So, their routine use postoperatively is not recommended, however, larger studies are required to confirm this.

Keywords: Acute appendicitis, uncomplicated appendicitis, antibiotics, postoperative wound infection.

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Corresponding Author

Nada Ayoub

Department of General Surgery, Western Sussex Hospitals, Worthing Hospital