Post-appendectomy wound infection: the role of prophylactic systemic antibiotics

ABSTRACT

Three swabs were taken from 200 cases of acute appendicitis of different pathological types. The peritoneal, appendicular and wound swabs were cultured aerobically and anaerobically to identify the causative oragnisms. Escherichia coli and Bacteroides fragilis represented about 75% of the causative organisms. The antibiotic sensitivity tests for the isolated bacteria showed that cefoperazone followed by cefotaxime were the most effective antibiotics in 75.8% and 71.2% respectively.The value of prophylactic systemic antibiotics in non complicated [early] and complicated [late] appendicitis to decrease the incidence of post-appendicectomy wound infection, had been studied using metronidazole with ampicillin for a group, cefoperazone in another and the third group didn't receive any antibotics. The two groups received prophylactic antibiotics showed lower incidence of wound infection than the third group. The group that was depending on cefoperazone as a prophylaxis, had a lower incidence of wound infection compared to the group received combination of metronidazole and ampicillin. Our series showed that aerobic and anaerobic bacteria are responsible for post- appendectomy wound infection which is commonly association especially in high- risk cases. Prophylactic systemic antibiotics are of value to decrease its incidence and the antibiotic must cover the aerobic and anaerobic bacteria. It is more effective and less economic to give a monotherapy covering the aerobic and anaerobic bacteria than to give a combination of double or even triple antibiotic regimen