Prophylactic lincomycin in the prevention of wound infection following appendicectomy: A double blind study

Abstract

The prophylactic use of a single dose of lincomycin in 100 patients undergoing appendicectomy reduced the incidence of postoperative wound infection from 17 to 6 per cent compared with a similar group of control patients. There was no correlation with the histological finding in the appendix, but patients with perforated appendicitis were excluded from the study. Bacteriological examination of the appendix area before surgery showed that Bacteroides fragilis and Escherichia coli were the organisms most frequently isolated. The majority of wound infections were due to B. fragilis, either alone or in association with aerobic organisms, but infection due to E. coli and Staphylococcus aureus also occurred. Systemic antibiotic therapy can successfully reduce the complications following appendicectomy but it is necessary to use a compound with activity against anaerobic organisms.

Perforated Appendix and Antibiotics

“…Antibiotie treatment directed towards colonic anaerobes is also known to diminish the rate of infectious complications after elective surgery of the colon (6,12). More reeently, similar findings have been reported on patients with appendicitis (2,5,13).…”

Intraoperative Antibiotika-prophylaxe bei der Appendizitis

“…Nach Analyse des bei der Appendizitis typischerweise anzutref fenden Keimspektrums [1] -insbesondere mit dem Nachweis der Anaerobier und ihrer Bedeutung für die Infektgenese -konn te man die Infektraten mit dem gegen Anaerobier wirksamen Metronidazol senken. Die Kombination von Metronidazol mit einem auch gegen die Aerobier wirksamen Antibiotikum scheint allerdings der Gabe von Metronidazol allein überlegen zu sein, wie Lau et al [2] nachweisen konnten und wie es für die kolo rektale Chirurgie belegt ist [3,4] …”

Randomized, prospective, and double-blind trial of new beta-lactams in the treatment of appendicitis

“…Efficacy decreases progressively until the antibiotics become of no real value when started 3 h thereafter (4,25). A single dose of antibiotic is effective (11,16,21), especially in early appendicitis with little peritoneal contamination. In late appendicitis with severe peritoneal soiling, the antibiotics should be continued for a full course.…”