Perforated appendicitis in children: use of metronidazole for the reduction of septic complications

Abstract

Fifty-four consecutive children with performed appendicitis were treated with intravenous and rectal metronidazole combined with another antimicrobial agent. Positive cultures were obtained from peritoneal swabs from all children except from four patients who produced no growth on culture. Mixed growth of aerobic and anaerobic organisms were isolated from 44 patients. Four patients had pure growth of aerobes and two had pure growth of anaerobes. Results were compared with 49 cases of performed appendicitis treated with a combination of Gentamicin and Cephradine and who did not receive metronidazole. The overall incidence of complications was reduced from 44.9% to 14.8%. A significant reduction in the incidence of wound infection (p less 0.01) and pelvic abscess (p less than 0.025) was observed in the metronidazole treated group. The period of hospitalization averaged 13.8 days in patients treated with metronidazole as compare to 18.2 days in those treated without metronidazole.