A Randomised Control Trial To Determine The Need For Post Operative Antibiotics After Laparoscopic Appendicectomy In Non Perforated Appendicitis

Abstract

Background and objectives Acute Appendicitis is one of the most common cause of acute pain in abdomen. The appropriate use of prophylactic antibiotics prevents risk of postoperative SSIs. However there are no definitive guidelines regarding duration of antibiotic usage. A single preoperative prophylactic dose has been recommended by many randomized control trials. This study was aimed to determine the need for post operative antibiotics after laparoscopic appendicectomy for non perforated appendicitis. Methodology This randomized controlled trial was done in the Department of General Surgery, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi over a period, from January 2015 to December 2015. A total of 100 patients with non perforated appendicitis undergoing laparoscopic appendicectomy were enrolled. These patients were divided into two groups of 50 each that is First group (Group A) who received single dose of preoperative antibiotic and Second group (Group B) who received preoperative dose as well as three post operative doses of antibiotics. Results In the present study, 44% of the patients in group A and 64% of the patients in group B were females. (p=0.0453) The mean age in group A was 30.74 ± 10.69 years compared to 30.72 ± 9.56 years (p=0.757). All the patients in study presented with right iliac fossa pain. It was observed that total of 3 patients in group A (6%) and 2 patients in Group B (4%) had grade 3 SSIs, which were managed conservatively. The difference between both the groups for incidence of SSIs is statistically insignificant (p=1.000). Conclusion and interpretation Prophylactic postoperative doses of antibiotics confer no additional benefit over a single preoperative dose in preventing the postoperative SSIs after laparoscopic appendicectomy.