Document Detail


Prophylactic metronidazole in appendectomy: a double-blind controlled trial.
MedLine Citation:
PMID:  6336864     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Ninety-eight patients with suspected nonperforated acute appendicitis have to date been entered into a continuing, prospective, blinded randomized trial to determine the role of prophylactic metronidazole in postoperative wound infection. Twenty-six patients were excluded for the following reasons: diagnosis other than acute appendicitis (16), perforation of the appendix (8), administration of other antibiotics (1), and refusal to enter study (1). Seventy-two patients, 47 men and 25 women, with a mean age of 27.5 years (range 15 to 60 years), underwent appendectomy and were studied. Thirty patients received 1 gm intravenous metronidazole preoperatively and five intravenous doses of 500 mg metronidazole postoperatively. Forty-two patients received placebo only. Cultures of the appendiceal stump grew aerobic cultures in 45 (62%) and anaerobic organisms in 29 (40%): Escherichia coli and Bacteroides fragilis, respectively. Six of the 72 patients (8.2%) developed postoperative wound infections: four of 42 (9.5%) who received placebo and two of 30 (6.6%) who received metronidazole (P = 0.54 by Fisher exact test). No toxicity from metronidazole was observed. The postoperative wound infection rate is insufficient to demonstrate the efficacy of metronidazole for prophylaxis in nonperforated acute appendicitis, although there appears to be a tendency of to assume its efficacy in this regard.
Authors:
T A Keiser; R L MacKenzie; R Feld; N Leers
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Surgery     Volume:  93     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1983 Jan 
Date Detail:
Created Date:  1983-02-25     Completed Date:  1983-02-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  201-3     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Appendectomy / adverse effects*
Bacteroides Infections / microbiology
Bacteroides fragilis / isolation & purification
Double-Blind Method
Escherichia coli Infections / microbiology
Female
Humans
Male
Metronidazole / therapeutic use*
Middle Aged
Premedication*
Prospective Studies
Random Allocation
Surgical Wound Infection / microbiology,  prevention & control*
Chemical
Reg. No./Substance:
443-48-1/Metronidazole

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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