Are routine peritoneal fluid cultures during appendicectomy justified?
BACKGROUND
To determine the impact of obtaining routine peritoneal fluid cultures during appendicectomy, on the treatment and the clinical outcomes.


METHODS
The case notes of 137 consecutive patients having appendicectomy, selected from the microbiology database over a period of 1 year were reviewed. The microorganisms in peritoneal cultures, selection of antibiotics and clinical outcomes were recorded. Patients were subdivided into two groups; group I: uncomplicated appendicitis and group II: complicated appendicitis.


RESULTS
The study included 137 patients with a median age of 19 years. Cultures were obtained from 79.5% of patients (group I: 67/84, group II: 42/53). Cultures were positive in 28.3% (19/67) patients in group I and 69% (29/ 42) in group II. Wound infection (5.6%), prolonged ileus (7.5%) and intra-abdominal abscess (3.7%) were the recorded complications in group II. Antibiotics were modified in 3 out of 109 patients.


CONCLUSIONS
Intra-operative peritoneal cultures during appendicectomy do not significantly contribute towards patient management.
Khan
M N
MN
Department of General Surgery, North Hampshire Hospital, Basingstoke, UK. Mkhan702@aol.com
Vidya
R
R
Lee
R E
RE
D018784:Abdominal Abscess / Q000175:diagnosis* / Q000517:prevention & control; D034841:Abdominal Cavity; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D001202:Ascitic Fluid / Q000737:chemistry / Q000382:microbiology*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D002444:Cefuroxime / Q000627:therapeutic use; D002478:Cells, Cultured; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D008795:Metronidazole; D002444:Cefuroxime