AB237. SOH26AB_0135. Variation in antibiotic treatment of acute appendicitis amongst surgeons
General Posters III

AB237. SOH26AB_0135. Variation in antibiotic treatment of acute appendicitis amongst surgeons

Emma Nolan1, Eibhlin Burns Beattie2, Mohamed Ismaiel2, Ellen Schuijt2, Adolph Wame2, Tara Connelly2,3

1Department of Biomedical Science, School of Medicine, University of Limerick, Limerick, Ireland; 2Department of Surgery, University Hospital Limerick, Limerick, Ireland; 3Health Research Institute (HRI), University of Limerick, Limerick, Ireland

Background: Very few guidelines for the immediate postoperative antibiotic treatment of appendicitis can be found in the literature. We aimed to determine local antibiotic treatment immediately post-appendectomy, prior to the return of results of culture and sensitivities of intraoperative microbiology swabs

Methods: All general surgery consultants and non-consultant hospital doctors (NCHDs) were contacted via grand rounds presentation and/or email to provide his or her typical treatment for various presentations of complicated appendicitis with photographic examples provided.

Results: Thirteen surgeons responded. All agreed on Augmentin as the antibiotic of choice for both mildly and moderately inflamed/gangrenous appendicitis; however, the route of administration varied [intravenous (IV) administration for mildly inflamed n=6 and moderately inflamed n=12]. Antibiotic duration varied from 0 to 7 days for mildly inflamed and 3–7 days for moderately/severely inflamed. The majority (n=11/84%) chose a single antibiotic for localised pus (Augmentin or piperacillin-tazobactam). All chose IV antibiotics with 15% adding a second line (gentamicin n=1 and metronidazole n=1). The only complete agreement between surgeons was when treating perforated with feculent contamination, where two surgeons agreed on Tazocin treatment and another two surgeons agreed on Tazocin and gentamicin treatment.

Conclusions: Variation in antibiotic type, addition of a second antibiotic, administration, and duration varied in this small cohort. A paucity of guidelines for postoperative administration of antibiotics for appendicitis is reflected in this small cohort study. This highlights the need for larger, multi-institutional studies and the creation of Irish guidelines.

Keywords: Appendicitis; appendectomy; antibiotics; general surgery; antimicrobials

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab237
Cite this abstract as: Nolan E, Beattie EB, Ismaiel M, Schuijt E, Wame A, Connelly T. AB237. SOH26AB_0135. Variation in antibiotic treatment of acute appendicitis amongst surgeons. Mesentery Peritoneum 2026;10:AB237.

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