Does Adjuvant Antibiotic Treatment After Drainage of Anorectal Abscess Prevent Development of Anal Fistulas? A Randomized, Placebo-Controlled, Double-Blind, Multicenter Study

Sozener, Ulas; Gedik, Ercan; Aşlar, Ahmet Keşşaf; Ergün, Hakan; Elhan, Atilla Halil; Memikoğlu, Osman; Erkek, Ayhan Bulent; Kuzu, Mehmet Ayhan

doi:10.1097/dcr.0b013e31821cc1f9

Cited by 88 publications

(64 citation statements)

References 20 publications

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“…Various factors related to the recurrence of anorectal abscesses such as age, sex, body mass index, onset time of symptoms, diabetes mellitus presence, place and anatomic classification of the abscess, antibiotic use, form of anesthesia and use of drain were investigated (7,12,14). In our study, no correlations could be identified between variables such as age, sex, hospi- (12,14).…”

Section: Discussionmentioning

confidence: 99%

A retrospective analysis of 93 cases with anorectal abscess in a rural state hospital

Akkapulu

Dere

Zaim

et al. 2015

UCD

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Objective: Anorectal abscess is a clinical condition frequently encountered in daily surgical practice and recurrences may occur despite treatment with adequate incision and drainage. The primary aim of this study was to analyze the variables that may have resulted in recurrent anorectal abscess, retrospectively. Material and Methods:Ninety-three patients out of 149 patients who underwent surgery for anorectal abscess at our center between 2011-2012 were included in this study. Data regarding age, gender, presence of recurrence, time to recurrence, abscess type, presence of fistula, fistula type, drain usage, length of hospital stay and follow-up duration were retrospectively recorded. Results:Patients were divided into two groups: the recurrence group and the treatment group. Eleven patients (11.8%) had a recurrence and the median time to recurrence was 3 months. None of the variables evaluated were found to be significantly associated with the presence of recurrence. Conclusion:Variables such as age, gender, type of abscess, presence of fistula or drain usage were not associated with the development of recurrence in patients who underwent incision and drainage of an anorectal abscess.

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Section: Discussionmentioning

confidence: 99%

A retrospective analysis of 93 cases with anorectal abscess in a rural state hospital

Akkapulu

Dere

Zaim

et al. 2015

UCD

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“…Die beschriebenen Arbeiten zeigen, dass nur ein Teil der wegen eines Abszesses Operierten sekundär wegen einer Fistel reoperiert werden musste. Nach Auswertung der Literatur führen lediglich 30% der Abszesse zu einer persistierenden Fistel [54,87,98].…”

Section: Häufigkeit Des Sekundären Fistelnachweisesunclassified

“…Deutlich niedriger war sie nach subanodermalen Abszessen mit 7,3%, nach intersphinkteren Abszessen mit 8,0% und nach ischioanalen Abszessen mit 10,9%. Ähnliche Ergebnisse mit höheren Fistelraten nach ischioanalen und intersphinkteren Abszessen gegenüber der subanodermalen Lokalisation beschreibt auch eine aktuelle Studie [98] [54]. In diesem Zusammenhang ist auf die weltweit zunehmende Resistenzentwicklung durch den unkritischen Einsatz von Antibiotika zu verweisen [49].…”

Section: Häufigkeit Des Sekundären Fistelnachweisesunclassified

“…Untersuchungen zur begleitenden Antibiotikatherapie nach Eröffnung von Abszessen der Körperoberfläche, die in den 1970er und 80er Jahren z. T. als randomisierte Studien durchgeführt wurden, ergaben keinen Vorteil für die begleitende Antibiotikatherapie[53,57,100]. Eine aktuelle randomisierte placebokontrollierte Doppelblindstudie[98] mit jeweils 92 Patienten fand im Ein-Jahres-Follow-up bei 29,8% eine Fistel (mit Antibiose 37,3%, ohne Antibiose 22,4%). Somit konnte kein Vorteil für eine perioperative Antibiose dargestellt werden.…”

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S3-Leitlinie: Analabszess

Ommer¹,

Herold²,

Berg³

et al. 2011

coloproctology

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“…Ommer et al, 2012 (30) showed that antibiotics should be used in the presence of immunosuppression. A randomized, controlled, multi-center clinical trial study showed that the use of antibiotics could not prevent the development of fistulas after ID of PA (31). Therefore, antibiotics should be combined with surgical measures.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Empirical Antibiotic Use for Uncomplicated Perianal Abscess and Fistula

Hasan¹

2016

Ann Colorectal Res

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Background: Perianal abscesses remain one of the most frequent surgical cases encountered by both general and colorectal surgeons. The use of broad-spectrum empirical antibiotics for perianal abscesses after drainage also remains common, although with questionable benefit. Objectives: The aim of the study conducted was to evaluate the role and efficacy of intra-and post-operative empirical antibiotic combination with a wide antibacterial spectrum for the treatment of perianal abscess and fistula-in-ano. Methods: An observational longitudinal study consisted of 150 patients; 50% of them underwent incision and drainage of their perianal abscess. The rest had fistula-in-ano and were treated with fistulotomy. Patients were prescribed a course of empiric antibiotics at the time of diagnosis. The prescribed antibiotic consisted of two regimes. The mechanism of the first regime was based on inhibiting bacterial cell wall synthesis, whereas the second regime included antibiotics inhibiting protein synthesis of the bacteria. Afterwards, analysis of the effect of postoperative use of empiric antibiotics was performed regarding symptom assessment, recurrence rate of abscess, fistula formation, cellulitis, bacteremia and sepsis. Results: Among 150 patients included in the study, 92% were male and 8% were female. The age range was 20 to 66 years (mean

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Does Adjuvant Antibiotic Treatment After Drainage of Anorectal Abscess Prevent Development of Anal Fistulas? A Randomized, Placebo-Controlled, Double-Blind, Multicenter Study

Abstract: Antibiotic treatment following the drainage of an anorectal abscess has no protective effect regarding risk of fistula formation.

Cited by 88 publications

References 20 publications

A retrospective analysis of 93 cases with anorectal abscess in a rural state hospital

A retrospective analysis of 93 cases with anorectal abscess in a rural state hospital

S3-Leitlinie: Analabszess

Postoperative Empirical Antibiotic Use for Uncomplicated Perianal Abscess and Fistula

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