Bacteriologic Study and Prophylactic Antibiotics in the Acute and Complicated Appendicitis

This prospective study was performed to determine the effective antibiotics for use in treating acute appendicitis patients during the perioperative period. To identify the sensitive antibiotics, the peritoneal fluid was cultured during operation. Also, wound infection was defined as pus or serous discharge in the wound or when we opened the wound under suspicious of a wound problem. The results were obtained as follows: 1) A total of 138 cases treated during the two years from January 1995 to December 1996 were examined; 84 of them (60.87%) were found to have positive peritoneal fluid cultures, of which 29 (34.52%) were monomicrobial and 55 (65.48%) were polymicrobial. 2) The most common species were Escherichia coli (73.81%), Bacteroides (32.14%), Klebsiella (16.67%), Pseudomonas (9.52%), and Streptococcus (9.52%). 3) In the sensitivity test, the most sensitive drugs were aminoglycosides and cefotaxime. 4) Infectious complications, which developed in 27 (19.6%) patients, were wound infection and intraabdominal abscess. 5) The average length of stay for all patients 9.9 days (range: 3 to 32 days). 6) The common organisms curtured from the complication cases were E. coli and Bacteroides.

Differences in Serum CEA Level between Colon and Rectal Cancer

We investigated whether there is differences in serum level of carcinoembryonic antigen (CEA) between patients with colon and rectal cancer. Preoperative serum levels of CEA was determined in 65 patients with colon cancer and in 88 patients with rectal cancer. Cut-off value recommended by manufacturers is 5 ng/ml for CEA. At the recommended cut-off levels for CEA, overall sensitivity of CEA was 43.1 percent for colon and 42.0 percent for rectal cancer. In colon cancer CEA was elevated in 38.4, 46.2, 60 percent of patients with Dukes Stages B, C, and D, respectively. In rectal cancer CEA was elevated in 12.5, 31.6, 44.8, 84.6 percent of patients with Dukes Stages A, B, C, and D, respectively. In Stages B, and C, sensitivity of CEA was higher in colon than in rectal cancer, but the difference was not significant. In Stages D, sensitivity of CEA was higher in rectal cancer than in colon cancer, but the difference was not significant. In overall stages sensitivity of CEA was higher in colon than in rectal cancer, but the difference was not significant. The difference was not significant either in overall or in different stages of colon and rectal cancer.