The optimal duration for postoperative antibiotics after appendicectomy? (AIIMS Nov 2011)
|A||1-2 days for perforated appendicitis|
|B||7-10 days for non-perforated appendicitis|
|C||7 – 10 days for perforated appendicitis|
|D||Intravenous antibiotics until the patient is afebrile has normal white blood cell count.|
(Ref: Schwartz :Principles of surgery th edition page no.141)
a. Antibiotic coverage is limited to 24 – 48 hrs in cases of non perforated appendicitis.
b. For perforated appendicitis, 7 to 10 days is recommended.
c. Intravenous antibiotics are usually given until WBC count is normal & the patient is afebrile for 24 hours.
d. Acute appendicitis is the most common acute surgical condition of the abdomen.
e. The disease occurs at all stages, but most frequent in second and third decades..
f. Obstruction of the lumen is the dominat cause in development of acute appendicitis.
g. To treat appendicitis with the use of only antibiotics is misguided as it ignores the obstructive pathology of the appendicitis.
h. So surgical intervention is the treatment for acute appendicitis.
i. Immediate appendectomy is indicated in patient without rupture just as soon as the minimal work-up compatible with safe operatives are done.
j. Ruptured appendicitis with local peritonitis should be operated upon early in the hospital course.
k. A brief period of observation is advisable when sufficient iv fluid is given.
l. Systemic antibiotics in large doses are administered.
m. Clindamycin should be the antibiotic used.
n. Antibiotics are continued for 3-5 days.
o. If patient improves, elective appendectomy after 3 weeks to 6months is strongly advised.