A comparison between imipenem and metronidazole prophylaxis against sepsis following appendicectomy.
A single preoperative dose of imipenem/cilastatin was compared with metronidazole for the prevention of infectious sequelae following emergency appendicectomy. Patients with established sepsis received in addition 72 h of either intravenous imipenem or ampicillin, gentamicin and metronidazole postoperatively. Two hundred and sixty-eight patients were studied. Wound infection rate in low-risk patients was 9% for metronidazole and 8% for imipenem. When sepsis was already established intraperitoneally the wound infection rate was 24% for the triple therapy regimen and 8% for imipenem. There was no statistically significant difference between the infection rates in the two groups of treatment whatever the state of the appendix, but there was a trend in favour of imipenem in those patients with a perforated appendix.
Burkitt
D S
DS
Department of Surgery, Dudley Road Hospital, Birmingham, UK.
Donovan
I A
IA
Wise
R
R
Lowe
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy; D002648:Child; D015377:Cilastatin / Q000008:administration & dosage / Q000627:therapeutic use*; D004338:Drug Combinations; D004630:Emergencies; D006801:Humans; D015378:Imipenem / Q000008:administration & dosage / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D011292:Premedication; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology
D004338:Drug Combinations; D008795:Metronidazole; D015377:Cilastatin; D015378:Imipenem