Does oral metronidazole reduce complications in acute appendicitis?

ABSTRACT

In order to determine the effect of oral metronidazole [OM] in acute appendicitis, a prospective study was carried out in 305 adult patients [age 15 - 50 yrs, mean 25.5 yrs], randomly divided into a study group [SG] and a control group [CG]. In uncomplicated cases, the SG received OM 500 mg 2 hours pre-operatively and starting 5-6 hours post-operatively every eight hours for a total of three doses. The same dose schedule was continued for another three to five days in the SG if the appendicitis was complicated. A routine combination of penicillin, chloramphenicol and gentamicin was administered for the CG in complicated cases. No drug reaction was observed. The rate of wound infection was similar in both groups presenting with the same degree of pathology. There was no intra-abdominal collection. Length of hospitalization was one day shorter and hospital cost per day was 50% less in complicated cases in the SG as compared to the CG. In conclusion, OM is a safe and cost-effective drug that can be used both in simple and complicated appendicitis