1982
DOI: 10.1007/bf01653546
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Antimicrobial prophylaxis in appendectomy patients

Abstract: Infection commonly follows removal of the gangrenous or perforated appendix. However, if the appendix is normal or simply acutely inflamed, the rate of infection is low. The organisms most frequently isolated from the wound after appendectomy are Bacteroides (especiallyB. fragilis) andEscherichia coli. A combination of chemoprophylaxis effective against these 2 groups of organisms is the most rational choice of antimicrobial cover. Such antimicrobial cover should be given to all patients with a gangrenous or p… Show more

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Cited by 14 publications
(7 citation statements)
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“…A significant reduction was achieved by the single-dose cefoxitin prophylaxis. A postsurgical infection rate of 13.3% in the treated group may be regarded as high, but corresponds to that of other studies [6,[12][13][14], About 30% of the patients undergoing surgery for pre sumed appendicitis have a gangrenous or perforated appendicitis, patient groups which clearly need antibi otic treatment [ 1,11,12,14,19], Gottrup [24] reported a postoperative infection rate of zero in patients with gan grenous appendicitis, when 500 mg metronidazole were given to all patients before appendectomy. We suspect that such results are hardly reproducible, the reason being a different definition of infectious complication and the follow-up scheme after discharge from hospital which relied on registrations by the general practitioners.…”
Section: Discussionmentioning
confidence: 99%
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“…A significant reduction was achieved by the single-dose cefoxitin prophylaxis. A postsurgical infection rate of 13.3% in the treated group may be regarded as high, but corresponds to that of other studies [6,[12][13][14], About 30% of the patients undergoing surgery for pre sumed appendicitis have a gangrenous or perforated appendicitis, patient groups which clearly need antibi otic treatment [ 1,11,12,14,19], Gottrup [24] reported a postoperative infection rate of zero in patients with gan grenous appendicitis, when 500 mg metronidazole were given to all patients before appendectomy. We suspect that such results are hardly reproducible, the reason being a different definition of infectious complication and the follow-up scheme after discharge from hospital which relied on registrations by the general practitioners.…”
Section: Discussionmentioning
confidence: 99%
“…Still the principles of prophylactic antibiotic usage would indicate parenteral administration, either imme diately before or during the operation to produce peak levels at the time of surgery. Clinical trials [6,14,26] suggest that a change from a general preoperative pro phylaxis to an individualized peroperative treatment of patients at high risk is cost effective.…”
Section: Discussionmentioning
confidence: 99%
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“…Den Fortschritten der Intensivmedizin und dem Einsatz geeigneter Antibiotika ist es zu verdanken, daß heute nahezu kein Kind mehr an einer Appendicitis perforata stirbt. Postoperative Komplikationen, insbesondere durch Wundabszesse, intraperitoneale Abszesse sind dagegen häufig, und die Morbidität nach Perforation einer Appendizitis wurde in der Literatur mit Raten zwischen 30% und 80% angegeben (4,7,13,19,20,22). Trotz der Anwendung verschiedener lokaler Maßnahmen wie Bauchhöhlenspülungen oder Drainagen schien gerade die Rate postoperativer Wundinfektionen und intraabdomineller Abszesse unbeeinflußbar zu bleiben, so daß einige Autoren eine grundsätzlich offene Wundbehandlung mit sekundärer Faszienhautnaht oder bei Fehlen von klinischen Sepsiszeichen sogar den völligen Verzicht auf eine antibiotische Behandlung empfahlen (1,9,12,21).…”
Section: Zusammenfassungunclassified