Abstract
Background: There is ongoing clinical discussion on the ideal length of antibiotic treatment after appendectomy for complicated appendicitis. With possible advantages including fewer hospital stays, fewer side effects, and cheaper medical expenses, shorter courses have been suggested as efficient substitutes for longer regimens.
Objective: This study aimed to compare the clinical outcomes of short-term (≤3 days) versus long-term (≥5 days) postoperative intravenous antibiotic therapy in patients undergoing surgery for complicated appendicitis.
Methods: A prospective observational cohort study was conducted on 180 patients with intraoperatively confirmed complicated appendicitis at an academic hospital in Iran. According to the physician’s discretion, patients were not randomized to receive either short-term or long-term antibiotic treatment. Clinical findings, length of antibiotic usage, hospital stay, surgical complications, and demographic information were all documented and examined.
Results: Both groups were similar in terms of age, sex, and severity of disease. The mean duration of antibiotic therapy and hospital stay were significantly shorter in the short-term group (3.2±0.7 days and 4.2±0.7 days, respectively) compared to the long-term group (5.7±1.2 days and 6.7±1.2 days; p<0.001). Postoperative fever was more frequent in the short-term group (31.1% vs. 17.8%; p=0.037), but there were no statistically significant differences between the groups in terms of surgical site infections or intra-abdominal abscess formation.
Conclusion: In patients with complicated appendicitis, short-term postoperative antibiotic treatment seems to be a safe and effective substitute for lengthier regimens, with the added benefits of shorter hospital stays and less exposure to antibiotics. These results underline the necessity of more randomized controlled studies to develop evidence-based recommendations for the length of antibiotics in these situations.
Keywords
Appendicitis, Antibiotic therapy, Complicated appendicitis, Postoperative complications