Peculiarities of course of operational and postoperative periods in appendectomy after various methods of the antibiotics introduction

Abstract

Objective. To study the peculiarities of antibiotics accumulation in appendix vermiformis after various methods of their introduction.
 Materials and methods. The investigation was conducted in 160 patients, to whom antibiotic was introduced by various methods: 53 – intramuscularly; 52
 – intravenously; 55 – lymphotropically. In part of the patients the antibiotic was introduced at 1 h preoperatively, and to the rest – at 2 h. After performance of appendectomy from each third part of the appendix vermiformis (proximal, middle and distal) excised a homogenate was made, which was sowed into Petri dish on the laboratory culture of E. coli. In a day there were stunting growth zones registered in this laboratory culture in millimeters, and in accordance to their dimensions the level of the antibiotic accumulation was determined.
 Results. After intramuscular introduction the antibacterial preparation in tissues of appendix vermiformis did not accumulate. After intravenous introduction of ceftriaxone at 1 h preoperatively it have accumulated in 65.4% patients in proximal and middle thirds of appendix vermiformis, in 34.6% patients in the appendix vermiformis apex the antibiotic accumulation was not observed. After the antibiotic introduction 2 h preoperatively its concentration have diminished in two times. After lymphotropic introduction the antibiotic have accumulated in all parts of appendix vermiformis, and in 2 h its quantity have enhanced significantly.
 Conclusion. Accumulation of antibiotic in the appendix vermiformis after it intravenous introduction have rapidly reduced, and after a lymphotropic one – enhanced, witnessing the advantage of lymphotropic method, which must become the alternative one in appendicitis, due to its targeticity and property for accumulation.

Controversies and Future Directions in Management of Acute Appendicitis: An Updated Comprehensive Review

“…However, the data on the use of postoperative antibiotics in patients with nonperforated appendicitis are less favorable. Studies suggest that a single preoperative antibiotic dose is sufficient to prevent postoperative complications in patients undergoing laparoscopic appendectomy for uncomplicated appendicitis, and postoperative antibiotics did not provide additional clinical benefit in this cohort, but, rather, may increase postoperative morbidity and length of hospital stay [ 48 , 53 , 54 , 55 , 56 , 57 ]. If perforation occurs, postoperative antibiotics are recommended and should be administered for a minimum period of 3–5 days until improvement in clinical and laboratory parameters is observed [ 49 , 55 ].…”