Optimal Duration of Antibiotics Following Appendectomy for Patients With Complicated Appendicitis

Background Complicated appendicitis patients typically undergo appendectomy followed by antibiotics. The optimal course of antibiotics for complicated appendicitis is poorly defined. Methods Data were collected from patients presenting with acute appendicitis and underwent appendectomy at the index...

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Bibliographic Details
Published in:The American surgeon 2021-03, Vol.87 (3), p.480-485
Main Authors: Panshin, Maclean S., Alnachoukati, Omar K., Schroeppel, Thomas J., Metzler, Michael, McFann, Kim, Dunn, Julie A.
Format: Article
Language:English
Subjects:
Abscesses
Adult
Aged
Anti-Bacterial Agents - administration & dosage
Anti-Bacterial Agents - therapeutic use
Antibiotics
Appendectomy
Appendicitis
Appendicitis - surgery
Appendix
Complications
Disease
Drug Administration Schedule
Female
Gangrene
Humans
Infections
Infectious diseases
Length of stay
Male
Middle Aged
Pain
Patients
Peritonitis
Postoperative Care - methods
Retrospective Studies
Surgery
Surgical site infections
Surgical Wound Infection - epidemiology
Surgical Wound Infection - prevention & control
Treatment Outcome
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Summary:Background Complicated appendicitis patients typically undergo appendectomy followed by antibiotics. The optimal course of antibiotics for complicated appendicitis is poorly defined. Methods Data were collected from patients presenting with acute appendicitis and underwent appendectomy at the index hospitalization (2015-2017). Primary outcomes were readmission rate, superficial surgical site infection (SSI), deep space infection (DSI), which includes abscess. Length of post-operative antibiotic use was recorded and an average intent-to-treat (ITT) by operative grade was calculated. Results Two hundred seventy-two patients (23%) were diagnosed with complicated appendicitis. SSI occurred in 4% of patients (n = 11); SSI rates ranged from 0% to 14.6% by ITT group with 3-4 days being the lowest (0%) and 6 days, we recommend limiting antibiotic treatment to 3-6 days for all complicated appendicitis cases with additional workup warranted if infectious symptoms persist.
ISSN:0003-1348
1555-9823
DOI:10.1177/0003134820947372