Comparative Study of Single Dose Per-operative Metronidazole versus Multiple Doses Postoperative Metronidazole in Acute Non-Complicated Appendicitis: A View on Postoperative Complications

Abstract

Background: It has now been proved by researches that per-operative single dose prophylactic antibiotics more crucial in preventing postoperative wound infection in elective cases and clean-contaminated cases like acutely inflamed non-perforated appendicitis. Aim and Objectives: This study investigated the effect of a single dose of metronidazole infusion per-operatively in the treatment of patients undergoing appendicectomy regarding postoperative infective complications. Material and Methods: A total number of 111 patients of non-complicated (suppurative and catarrhal) appendicitis enrolled in this prospective study between October 2015 and October 2017. Patients were allocated to two groups in a randomized way. Fifty-one patients in Group A were given a single dose of metronidazole per-operatively. Sixty patients in Group B were given multiple doses of metronidazole postoperatively. Postoperative fever, wound infection, seroma, and intrabdominal collections were compared between both groups. Statistical analysis was performed using Student's t-test and Chi-square test. Results: The patients of both groups were similar in baseline characteristics. No significant difference was found in the rate of postoperative fever and wound infection in both groups. In Group A there were five patients (9%) developed postoperative fever, four of them (7.8%) because of wound infection. In Group B there were six patients (10%) developed postoperative fever, four of them (6.7%) because of wound infection. None of the patients developed seroma or intraabdominal abscesses. Conclusion: Single per-operative dose of metronidazole is quite effective in reducing the incidence of postoperative fever

Keywords

• Appendicitis
• Appendicectomy
• Wound infection
• Postoperative fever
• Metronidazole