| Nonperforative appendicitis: a continuing surgical dilemma. | |
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MedLine Citation:
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PMID: 2656877 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Acute appendicitis continues as a medical challenge with newer approaches failing to improve diagnostic accuracy. The role of antibiotics in acute nonperforative appendicitis (NPA) remains unclear. In 175 patients studied at two hospitals, preoperative guidelines were used to exclude perforative appendicitis. Nevertheless, 14% of patients were found to have this condition. Surgeon's reports significantly underestimated the diagnosis when compared with the pathologists' reports. Antibiotic prophylaxis in 122 patients with NPA was studied prospectively comparing ceftizoxime (CTZ), cefamandole (CFM), and placebo (PLA). Ceftizoxime decreased the infection rate compared with PLA (0 vs. 8; P less than .01). Use of antibiotics (CTZ or CFM) resulted in decreased infections when compared with PLA (3 vs. 8; P less than .01) and fewer days of hospitalization (3.8 vs. 5.4 d, P less than .005). Analysis of infection risk factors showed no correlations except for failure to administer antibiotics and the finding of a gangrenous appendix. Operative culture results had no predictive value for either infection or pathogen identification. It is recommended that all patients undergoing surgery for NPA be given 1 d of antibiotic prophylaxis. |
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Authors:
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W Browder; J W Smith; L M Vivoda; R L Nichols |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Journal of infectious diseases Volume: 159 ISSN: 0022-1899 ISO Abbreviation: J. Infect. Dis. Publication Date: 1989 Jun |
Date Detail:
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Created Date: 1989-06-30 Completed Date: 1989-06-30 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0413675 Medline TA: J Infect Dis Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1088-94 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adolescent Adult Aged Appendicitis / diagnosis*, surgery Ascitic Fluid / microbiology Bacterial Infections / prevention & control* Cefamandole / therapeutic use* Ceftizoxime / therapeutic use* Child Clinical Trials as Topic Diagnostic Errors Double-Blind Method Female Humans Male Middle Aged Premedication* Prospective Studies Random Allocation Risk Factors |
| Chemical | |
Reg. No./Substance:
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34444-01-4/Cefamandole; 68401-81-0/Ceftizoxime |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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