Philippine Journal of Surgical Specialties Vol. 75, No. 2, July-December 2020, pp 141-147
Short-Course Versus Long-Course Antibiotic Therapy For Complicated Appendicitis: A Meta-analysis
Author(s): Jayme Natasha K. Paggao, MD; Omar O. Ocampo, MD, FPSGS, FPSCRS, FPCS and Domingo S. Bongala, Jr., MD, FPSGS, FPCS
Abstract:
Objective: To compare the efficacy of short course versus long course antibiotic therapy among patients undergoing appendectomy for complicated appendicitis.
Methods: The authors conducted an electronic search of PubMed, Cochrane Library, and EBSCO Host for studies from 2000 to January, 2000 to September, 2018 comparing short-course versus long-course antibiotic therapy in adults undergoing appendectomy for complicated appendicitis. The outcomes considered were the incidence of superficial surgical site infection and intra-abdominal abscess, and duration of hospital stay. Meta-analysis was performed using Review Manager software.
Results: A total of 360 patients in two studies were analyzed. Superficial surgical site infection was identified in 5 out of 123 patients in the short-course antibiotic group (4%), and 5 out of 237 patients in the long-course antibiotic group (2.1%) (95% CI 0.38, 5.51, p=0.58). There was a decrease in the incidence of intra-abdominal abscess in the short-course antibiotic group (6.5%), but the difference was not statistically significant (95% CI 0.32, 1.77, p=0.52). The duration of hospital stay was significantly less in the short-course antibiotic group (3.95 days) compared to the long-course antibiotic group (4.6 days) (95% CI -0.66, -0.21; p< 0.001). Conclusion: No difference between the <5-day and >5-day antibiotic course in terms of surgical site infection and intra-abdominal abscess was detected. However, the hospital stay of the
Key words: Surgical wound infection, anti-bacterial agents, length of stay, appendectomy, abdominal abscess