title: Antimicrobial treatment after laparoscopic appendectomy for preventing a post-operative intraabdominal abscess: A Prospective Cohort Study of 1817 patients.
abstract: BACKGROUND
  Post-operative antimicrobial treatment is usually administered to prevent a post-operative intraabdominal abscess (IAA) after laparoscopic appendectomy (LA). The aim of this study was to identify the role of post-operative antibiotic treatment and the optimal length for the antibiotic course to prevent post-operative IAA after LA.
  
  
  METHODS
  Between January 2010 and December 2013, 1817 patients who underwent three-port LA were enrolled in this study. Patients were classified into four groups according to the type of appendicitis and infectious source control. The characteristics of antimicrobial treatment and the incidence of IAA were analyzed and compared among the four groups.
  
  
  RESULTS
  The incidence of IAA after three-port LA was 1.5% (27/1817). The mean durations of post-operative antibiotic use were 3.1 days for the non-IAA group and 3.3 days for the IAA group, with no significant difference between the groups (p = 0.510).
  
  
  CONCLUSIONS
  The length of post-operative antibiotic treatment and antimicrobial combination therapy did not affect the development of IAA, and prolonged antibiotic treatment did not prevent IAA. However, when source control was not completely achieved, an IAA was frequently observed in the patient group that received a short course of antibiotic treatment.
  
  
  CONCLUSIONS
  The role of antibiotic treatment for preventing post-appendectomy IAA seems to be related with achieving intraperitoneal infectious source control. In the setting of incomplete source control, we recommend a 5-day course of antimicrobial combination therapy and consecutive source control such as peritoneal drainage.
authors.affiliation: Department of Surgery, Bucheon St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Sosa-dong, Wonmi-gu, Bucheon-si, Gyunggi-do 420-717, South Korea. Electronic address: jinbum21@catholic.ac.kr.
authors.forename: Jinbeom
authors.initials: J
authors.lastname: Cho
authors.affiliation: Department of Surgery, Bucheon St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Sosa-dong, Wonmi-gu, Bucheon-si, Gyunggi-do 420-717, South Korea. Electronic address: parkiy@catholic.ac.kr.
authors.forename: Ilyoung
authors.initials: I
authors.lastname: Park
authors.affiliation: Department of Surgery, Bucheon St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Sosa-dong, Wonmi-gu, Bucheon-si, Gyunggi-do 420-717, South Korea. Electronic address: dosangs@catholic.ac.kra.
authors.forename: Dosang
authors.initials: D
authors.lastname: Lee
authors.affiliation: Department of Surgery, Bucheon St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Sosa-dong, Wonmi-gu, Bucheon-si, Gyunggi-do 420-717, South Korea. Electronic address: skyhfh@catholic.ac.kr.
authors.forename: Kiyoung
authors.initials: K
authors.lastname: Sung
authors.affiliation: Department of Surgery, Bucheon St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Sosa-dong, Wonmi-gu, Bucheon-si, Gyunggi-do 420-717, South Korea. Electronic address: jmbaek99@gmail.com.
authors.forename: Jongmin
authors.initials: J
authors.lastname: Baek
authors.affiliation: Department of Surgery, Bucheon St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Sosa-dong, Wonmi-gu, Bucheon-si, Gyunggi-do 420-717, South Korea. Electronic address: surgeryjun@catholic.ac.kr.
authors.forename: Junhyun
authors.initials: J
authors.lastname: Lee
mesh_terms: D018784:Abdominal Abscess / Q000453:epidemiology* / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001062:Appendectomy / Q000009:adverse effects*; D001064:Appendicitis / Q000382:microbiology / Q000601:surgery*; D015331:Cohort Studies; D004322:Drainage; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Intraabdominal abscess; Laparoscopic appendectomy; Post-operative antibiotics