Prophylaxis With Single Versus Five Dose of Antibiotic Therapy as Treatment of Patients With Gangrenous Acute Appendicitis
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Purpose
A prospective, randomized controlled clinical trial was conducted at the Hospital Universitario de Santander to test the effectiveness of providing a single 1-dose therapy of antibiotic prophylaxis versus a 5-day antibiotic therapy in patients with acute gangrenous appendicitis.
| Condition | Intervention |
|---|---|
|
Gangrenous Appendicitis |
Other: prophylaxis Other: therapy |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Prophylaxis With Single Versus Five Dose of Antibiotic Therapy as Treatment of Patients With Gangrenous Acute Appendicitis (Randomized, Controlled Clinical Trial) |
- wound infection [ Time Frame: 30 days ] [ Designated as safety issue: Yes ]Signs of surgical wound infection as heat, pain, erythema and secretion with involvement of skin,subcutaneous tissue and organ or space
- Length of the hospital stay [ Time Frame: 30 days ] [ Designated as safety issue: Yes ]Duration in days from admission until discharge
- Adverse effects treatment related [ Time Frame: 30 days ] [ Designated as safety issue: Yes ]Adverse effects derived from the usage of antibiotics
| Enrollment: | 150 |
| Study Start Date: | December 2007 |
| Study Completion Date: | February 2010 |
| Primary Completion Date: | November 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Antibiotic prophylaxis
Rate of Wound infection in patients with gangrenous appendicitis with single doses of antibiotic (before surgery)
|
Other: prophylaxis
single doses of antibiotics before surgery in patients with gangrenous appendicitis Metronidazole 500 mg IV + amikacin 1 gr IV
|
|
Active Comparator: Antibiotic treatment, wound infection
Rate of Wound infection in patients with gangrenous appendicitis with five days antibiotic therapy (after surgery)
|
Other: therapy
antibiotic treatment (5 days) therapy in patients with gangrenous appendicitis metronidazole 500 mg IV three times a day + amikacin 1 gr IV per day
|
Detailed Description:
Introduction: For patients with acute gangrenous appendicitis, it is common to provide antibiotics during 5-7 days in order to reduce the incidence of infection of the surgical wound; however the benefit of such treatment has not been tested. A prospective, randomized controlled clinical trial was conducted at the Hospital Universitario de Santander to test the effectiveness of providing a single 1-dose therapy of antibiotic prophylaxis versus a 5-day antibiotic therapy in patients with acute gangrenous appendicitis.
Materials and Methods: From December 2007 to November 2009, 799 patients went through surgery after being diagnosed with acute appendicitis. Out of this set, 150 patients diagnosed with acute gangrenous appendicitis, were randomly assigned to one of two groups: control group (group A: 72 patients received a 5-day antibiotic therapy), and treatment group (group B: 78 patients received a single 1-dose of antibiotic prophylaxis). The experimental outcomes included: the incidence of infection of the surgical wound, the length of the hospital stay, and the adverse effects derived from a prolonged use of antibiotics.
Eligibility| Ages Eligible for Study: | 12 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- patients with diagnosis of acute appendicitis with intraoperative finding of a gangrenous appendix who accepted to enter the study
Exclusion Criteria:
- patients under 12 or older 65 years old
- Patients with possible immunosuppression such as diabetes, cancer, kidney failure, liver failure
- Pregnancy
- Patients who have received antibiotic treatment within seven days before surgery
- Patients difficult to monitor or follow up
Contacts and Locations| Colombia | |
| Hospital Universitario de Santander | |
| Bucaramanga, Santander, Colombia, 097 | |
| Principal Investigator: | Henry A Uscategui, Physician | Universidad Industrial de Santander |
| Study Director: | Francisco Camacho, Physician | Universidad Industrial de Santander |
More Information
Publications:
| Responsible Party: | Henry Uscategui Cristancho, General Surgeon, Universidad Industrial de Santander |
| ClinicalTrials.gov Identifier: | NCT01115153 History of Changes |
| Other Study ID Numbers: | 74186942 |
| Study First Received: | April 19, 2010 |
| Last Updated: | August 22, 2011 |
| Health Authority: | Colombia: Institutional Review Board |
Keywords provided by Universidad Industrial de Santander:
|
Acute appendicitis Antibiotic prophylaxis Wound infection Nosocomial infection |
Additional relevant MeSH terms:
|
Appendicitis Acute Disease Gangrene Gastroenteritis Gastrointestinal Diseases Digestive System Diseases Cecal Diseases Intestinal Diseases |
Disease Attributes Pathologic Processes Necrosis Anti-Bacterial Agents Anti-Infective Agents Therapeutic Uses Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 22, 2013