Antibiotic prevention and appendectomy. Practical consequences for health economics. Apropos of a series of 642 cases

: A total of 642 patients undergoing appendicectomy were divided into two groups of 321 patients prior to surgery. One group (A) received prophylactic antibiotic therapy, the other (B) no previous treatment. Patients were from the same region and groups were comparable for age, sex and indications for operation. Antibiotic treatment was administered according to a personal protocol based on gross appearance of appendix, and involved two molecules: Baypen in 69 cases and cephamycin (Mefoxin) in the other 252. Although not a randomized trial, the protocol was considered effective for prevention of postoperative infectious complications. In the group A, 21 patients (6.54%) developed these complications as against only 3 (0.93%) in group B, a significant difference if the total group B is considered or the two antibiotic subgroups. However, no valid conclusion can be drawn in favor of one or other of the two molecules. This effective procedure reduces by a half the duration of postoperative hospital stay for patients with a simple acute or a chronic appendicitis accepting the follow up surveillance required by the protocol. This attitude should be extended to a larger number of patients with resulting non-negligible health costs economy.