Postoperative Empirical Antibiotic Use for Uncomplicated Perianal Abscess and Fistula

Abstract

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

Efficacy of amoxicillin/clavulanic acid after surgical drainage of perianal abscess in the prevention of the development of anal fistula (PERIQxA study): study protocol for a multicenter randomized, double-blind clinical trial

“…Published data are limited and sometimes contradictory. Different observational studies have been conducted with heterogeneous results [7,[13][14][15]. Only two randomized clinical trials have evaluated the prophylactic use of antibiotics in this setting [5,6].…”