The clinical application of bacteriological results of antibiotic prophylaxis for appendicectomy

Culture results from intra-operative peritoneal swabs taken in 85 cases of perforated and gangrenous appendicitis at Princess Margaret Hospital for Children (PMH) from January 1982 until December 1984 were analysed. All were given preoperative antibiotic therapy. Sixty-one specimens were culture positive, yielding 134 isolates comprising bacteria from 13 different groups. Escherichia coli (E. coli) was the most common organism cultured, being found in 82% of patients with positive cultures. Six different bacterial groups accounted for 91% of all isolates (122 of 134). The combination of ampicillin, gentamycin, and metronidazole provided the most comprehensive antibiotic cover for all bacteria cultured. This combination was also the least expensive and was associated with a satisfactory clinical outcome.