title: Postoperative antibiotic use and the incidence of intra-abdominal abscess in the setting of suppurative appendicitis: a retrospective analysis.
abstract: BACKGROUND
  Although guidelines exist for postoperative antibiotic use in acute appendicitis that is perforated, gangrenous, or simple/uncomplicated, there are less data about its use in suppurative appendicitis. Here, we targeted this subgroup of patients to determine whether postoperative antibiotic administration affects incidence of intra-abdominal abscess formation.
  
  
  METHODS
  We retrospectively examined 1,192 patients who underwent laparoscopic appendectomy for acute appendicitis at Kaiser Permanente Fontana Hospital between August 2010 and August 2013. Suppurative appendicitis was described for 143 (12%) patients. Fifty-two patients received postoperative antibiotics for at least 1 week on discharge home, 91 did not.
  
  
  RESULTS
  Of 143 patients with suppurative appendicitis, 1 (1.9%) who received postoperative antibiotics came back with an intra-abdominal abscess within 1 month. Of the 91 patients in the no antibiotic group, 1 (1.1%) came back with an intra-abdominal abscess.
  
  
  CONCLUSIONS
  The administration of postoperative antibiotic in the setting of suppurative appendicitis has no effect on the rate of intra-abdominal abscess formation. Routine postoperative antibiotics may not be necessary in this patient population, and more evidence is needed to justify its use.
authors.affiliation: Department of General Surgery, Arrowhead Regional Medical Center/Kaiser Permanente Fontana General Surgery, 400 N Pepper Ave, Colton, CA 92324, USA. Electronic address: estherbaedo@gmail.com.
authors.forename: Esther
authors.initials: E
authors.lastname: Bae
authors.affiliation: John Wayne Cancer Institute, Santa Monica, CA, USA.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Dehal
authors.affiliation: Department of General Surgery, Arrowhead Regional Medical Center/Kaiser Permanente Fontana General Surgery, 400 N Pepper Ave, Colton, CA 92324, USA.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Franz
authors.affiliation: LSU Heath Sciences Center-New Orleans, General Surgery, New Orleans, LA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Joannides
authors.affiliation: Arrowhead Regional Medical Center, Department of Internal Medicine, Colton, CA, USA.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Sakis
authors.affiliation: Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Scurlock
authors.affiliation: Department of General and Colorectal Surgery, Kaiser Permanente SCPMG, Fontana, CA, USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Nguyen
authors.affiliation: Arrowhead Regional Medical Center, Department of General Surgery, Colton, CA, USA.
authors.forename: Farabi
authors.initials: F
authors.lastname: Hussain
mesh_terms: D018784:Abdominal Abscess / Q000453:epidemiology*; D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001062:Appendectomy; D001064:Appendicitis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D008297:Male; D011182:Postoperative Care; D012189:Retrospective Studies; D013492:Suppuration; D013530:Surgical Wound Infection / Q000453:epidemiology*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic stewardship; Complications; Infection; Intra-abdominal abscess; Suppurative appendicitis