Short-course versus long-course antibiotic therapy for complicated appendicitis: A meta-analysis

ABSTRACT

OBJECTIVE@#To compare the efficacy of short-course versus longcourse antibiotic therapy among patients undergoing appendectomy for complicated appendicitis.@*METHODS@#The authors conducted an electronic search of PubMed, Cochrane Library, and EBSCOHost for studies from 2000 to January, 2000 to September, 2018 comparing short-course versus long-course antibiotic therapy in adults undergoing appendectomy for complicated appendicitis. The outcomes considered were the incidence of superficial surgical site infection and intra-abdominal abscess, and duration of hospital stay. Meta-analysis was performed using Review Manager software.@*RESULTS@#A total of 360 patients in two studies were analyzed. Superficial surgical site infection was identified in 5 out of 123 patients in the short-course antibiotic group (4%), and 5 out of 237 patients in the long-course antibiotic group (2.1%) (95% CI 0.38, 5.51, p=0.58). There was a decrease in the incidence of intra-abdominal abscess in the short-course antibiotic group (6.5%), but the difference was not statistically significant (95% CI 0.32, 1.77, p=0.52). The duration of hospital stay was significantly less in the short-course antibiotic group (3.95 days) compared to the long-course antibiotic group (4.6 days) (95% CI -0.66, -0.21; p<0.001). @*CONCLUSION@#No difference between the <5-day and ≥5-day antibiotic course in terms of surgical site infection and intra-abdominal abscess was detected. However, the hospital stay of the <5-day group was shorter.