A single dose of antibiotics may be just as effective as multiple doses in preventing infections after an appendectomy, a new research review confirms.
Researchers at Bispebjerg Hospital in Copenhagen analyzed 45 controlled clinical trials in which antibiotics to fight wound infections following appendectomies were compared with placebo. Sixteen of the trials also included data on the development of an intra-abdominal abscess, or an infected pocket of pus formed by a ruptured appendix. In all, 9,576 patients were included in the analyses.
The review found that antibiotic injections do work no matter how diseased the appendix was or whether it was diseased at all. This is significant, because some surgeons contend that antibiotics should be used only when the appendix is at a more advanced stage of disease.
The study also indicates that a single antibiotic dose has the same impact as multiple doses, and that if multiple doses are used, it does not matter whether they are given before, during or after the operation.
The study appears in the July issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that produces systematic reviews of healthcare interventions, based on the content and quality of existing clinical trials on the topic.
"I don't think that there is any controversy any longer about whether antibiotics work," says co-author Henning Andersen, Ph.D. "What we need to focus on now are factors such as dosage, administration time and length of administration. Why give patients a lot of antibiotics if just one shot could help prevent wound infection or abscess?"
Andersen says that the most important reason for giving a single dose rather than multiple doses is to prevent the development of antibiotic resistance. "Cost is not really a factor," says Andersen. "Antibiotics are fairly inexpensive drugs, so it's not from an economic point of view that you should reduce their use. You should reduce their use so that you won't develop resistance."