Document Detail


Peritoneal cultures and antibiotic treatment in patients with perforated appendicitis.
MedLine Citation:
PMID:  11316408     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To question the common practice of sending material for microbiological examination during appendicectomy for perforated appendixes. DESIGN: Uncontrolled retrospective study. SETTING: Teaching hospital, Israel. SUBJECTS: 89 patients who had their perforated appendixes removed. INTERVENTIONS: Appendicectomy and antibiotic treatment. MAIN OUTCOME MEASURE: Whether a change in antibiotic regimen was required after bacteriological identification of bacteria isolated during the operation. RESULTS: In only 43 of the cultures (48%) taken during the operation were bacteria grown, and these were mainly Escherichia coli. In 65 patients (73%) there was no need to change the previously initiated antibiotic regimen, and in 23 (26%) it was changed purely on clinical grounds. In only one patient (1%) was the change the consequence of microbiological testing, as the organisms identified in 42 of the 43 cultures (98%) were sensitive to at least one of the antibiotics that had already been given. CONCLUSION: The practice of culturing samples taken from a ruptured appendix is redundant, because the antibiotic that has already been initiated is effective in most of the patients and the decision to modify the therapeutic regimen is dominated by clinical considerations.
Authors:
D Soffer; S Zait; J Klausner; Y Kluger
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The European journal of surgery = Acta chirurgica     Volume:  167     ISSN:  1102-4151     ISO Abbreviation:  Eur J Surg     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-04-23     Completed Date:  2001-08-30     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  9105264     Medline TA:  Eur J Surg     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  214-6     Citation Subset:  IM    
Affiliation:
The Department of Surgery B, Tel-Aviv Sourasky Medical Centre and the Sackler Faculty of Medicine, Tel-Aviv University, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents*
Antibiotic Prophylaxis*
Appendectomy
Appendicitis / microbiology*,  surgery
Drug Therapy, Combination / therapeutic use*
Female
Humans
Intestinal Perforation / microbiology*,  surgery
Male
Middle Aged
Peritoneum / microbiology*
Retrospective Studies
Rupture, Spontaneous
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents
Comments/Corrections
Comment In:
Eur J Surg. 2001 Mar;167(3):217   [PMID:  11316409 ]

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