Peritoneal cultures and antibiotic treatment in patients with perforated appendicitis.
OBJECTIVE
To question the common practice of sending material for microbiological examination during appendicectomy for perforated appendixes.


METHODS
Uncontrolled retrospective study.


METHODS
Teaching hospital, Israel.


METHODS
89 patients who had their perforated appendixes removed.


METHODS
Appendicectomy and antibiotic treatment.


METHODS
Whether a change in antibiotic regimen was required after bacteriological identification of bacteria isolated during the operation.


RESULTS
In only 43 of the cultures (48%) taken during the operation were bacteria grown, and these were mainly Escherichia coli. In 65 patients (73%) there was no need to change the previously initiated antibiotic regimen, and in 23 (26%) it was changed purely on clinical grounds. In only one patient (1%) was the change the consequence of microbiological testing, as the organisms identified in 42 of the 43 cultures (98%) were sensitive to at least one of the antibiotics that had already been given.


CONCLUSIONS
The practice of culturing samples taken from a ruptured appendix is redundant, because the antibiotic that has already been initiated is effective in most of the patients and the decision to modify the therapeutic regimen is dominated by clinical considerations.
Soffer
D
D
The Department of Surgery B, Tel-Aviv Sourasky Medical Centre and the Sackler Faculty of Medicine, Tel-Aviv University, Israel.
Zait
S
S
Klausner
J
J
Kluger
Y
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents; D019072:Antibiotic Prophylaxis; D001062:Appendectomy; D001064:Appendicitis / Q000382:microbiology* / Q000601:surgery; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000382:microbiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010537:Peritoneum / Q000382:microbiology*; D012189:Retrospective Studies; D012422:Rupture, Spontaneous
D000900:Anti-Bacterial Agents