Antibiotics Use in Patients Underwent Appendecectomy at North Middlesex Hospital/ London: A Retrospective Analysis

Geddoa, Emad

	Antibiotics Use in Patients Underwent Appendecectomy at North Middlesex Hospital/ London: A Retrospective Analysis
Kerbala Journal of Medicine
Article 1, Volume 9, Issue 2, 2016, Pages 2443-2450 PDF (0 K)
Author
Emad Geddoa
Abstract
background: Appendicitis is a common condition that affects patients of all ages. Appendecectomy has been the mainstay for the treatment of acute appendicitis since first reported by McBurney in 1889. Aim: To describe the effect and outcome of using antibiotics before appendecectomy, and assess whether antibiotic is being used appropriately in patients who have had appendecectomies. The study has also draw conclusions around the impact of inappropriate antibiotic use. Method: This is a retrospective study at North Middlesex University Hospital „NMUH‟ in London over the period of one year .100 patient notes, those had appendecetomies, were collected on this study between April 2012 and March 2013. The following systems were approached: Admission clerking, Histopathology system, Patient Admission System, Radiology system (PACS), Anesthetic chart, Operation note, Drug chart, and Discharge summary. Results: 22% of patients had histologically normal appendix and 13% of patients had histologically inflamed appendix were received no prophylactic antibiotics (Augmentin or Clarithromycin if allergic to penicillin + Flagyl). Also 13% of those had histologically proved gangrenous / perforated appendix received no course of antibiotics postoperatively. On the other hand, 11% of those had histologically normal appendix and 30% of patients who had histologically proven mild appendicitis were received unnecessary course of antibiotics after surgery. Conclusion: 10% of patients had appendecectomies received no prophylactic antibiotic at all. Patients who developed postoperative complications (such as ileus, pelvic collection and surgical site infection) were mainly those who had no antibiotics before surgery. An agreed protocol for antibiotic use is needed to avoid erratic prescription of antibiotic. Also Patients should be followed up after discharge to assess for complication and review histology.

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