Abstract

EMPIRICAL ANTIMICROBIALS USED IN THE TREATMENT OF APPENDICITIS

Nilsha Anil Sundaresan*, Shafad Illath, M. Arun, P. Umapathi and R.T.Saravanakumar

ABSTRACT

Introduction: The need for empiric therapy is to prevent postoperative infections, which are the primary cause of morbidity and mortality in patients undergoing surgery today. Our main objective was to study the empirical antimicrobial therapy prescribed for appendicitis patients and to observe the common microorganism, its resistance and identify the cost effectiveness based on sensitivity pattern in RMMCH. Methodology: In the six month study, a total of one hundred patients undergoing appendectomy surgery, were enrolled in this observational study. It was found that combination of two or three antimicrobial agents was preferred in appendicitis surgeries. Three types of empirical antimicrobial treatment options were used during this study period. (Treatment 1 : Cefotaxime 1 g i.vbd + Metronidazole 500 mg i.vbd, Treatment 2: Cefotaxime 1 g i.vbd + Metronidazole 500 mg i.vbd + Gentamicin 80 mg i.vbd and Treatment 3: Ceftriaxone 1 g i.vbd + Metronidazole 500 mg i.vbd + Gentamicin 80 mg i.vbd). Results: There was no statistical significant difference in the incidence of rate of infection. The cost of the treatment 3 was found to around 2-3 times that of other treatments. Among all, treatment 1(Cefotaxime 1 gm + Metronidazole 500 mg) was found to be cost effective with least incidence of post-operative infection. Conclusion: Thus, no significant increase in resistance rates of pathogens in appendicitis was found over the last 6 months. Empirical antimicrobial protocols currently recommended remain efficient on particular pathogens.

Keywords: Empirical antimicrobials, Metronidazole, Cefotaxime, Gentamicin, Appendicitis.