Acute nonperforating appendicitis. Efficacy of brief antibiotic prophylaxis

R. E. Winslow, R. E. Dean and J. W. Harley

A prospective, randomized, double-blind clinical study was performed to determine the efficacy of perioperative systemic antibiotics in preventing infection after appendectomy for acute nonperforating appendicitis. One hundred three patients received three doses of either placebo (saline, n = 52) or cefoxitin sodium (n = 51). The two groups were similar with regard to age distribution, sex ratio, duration of operation, pathologic condition of appendix, and hospital stay. Postoperative wound infections were detected in 9.6% of the placebo-treated patients, whereas none occurred in the cefoxitin group. All but one infection appeared after discharge. Cost analysis identified a net savings of $ 84 per patient with the use of prophylactic antibiotics. Septic morbidity after appendectomy for nonperforating appendicitis is significantly reduced by systemic antibiotics, and brief administration of a single broad-spectrum agent (cefoxitin) is effective prophylaxis.