Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085693 (acute appendicitis)
 3,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A retrospective study on the microbiology of abdominal pus from acute appendicitis or peritonitis was carried out by the authors. A total of 45 specimens were examined, 38 of them (84.4%) where found to be positive, of which 29 (76.3%) were polymicrobial and 9 (23.7%) were monomicrobial. The most represented species were Escherichia coli (28.4%), Bacteroides fragilis (7.8%), Streptococcus milleri (7.8%), Bacteroides oralis (3.9%) and Pseudomonas aeruginosa (3.9%). The polymicrobial associations more represented include Bacteroidaceae, Enterobacteriaceae and streptococcus genus. The most active drugs in vitro were found to be Piperacillin and Chloramphenicol, Cephalosporin (cefotaxime, ceftriaxone and cefoxitin) showed a good capability of being active against isolated microorganisms although they were less effective when used against anaerobic microorganisms then aerobic ones. On the contrary, Rifampicin, Metronidazole and Clindamycin were found to be quite effective against the anaerobes.
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PMID:[Bacteriology of abdominal pus in 43 cases of acute appendicitis and appendiceal abscess at the Ivrea-Castellamonte Hospital, isolation of aerobic and anaerobic bacteria and drug sensitivity]. 184 22

Metronidazole was used for treatment of 212 patients with peritonitis of appendicular origin. It resulted in lowered leukocytosis, elimination of the stab neutrophil shift, earlier reduction of the leukocyte intoxication index. The amount of suppurations of postoperative wounds decreased from 17% to 4.3%. The amount of reoperations was 2.4% instead of 5.4%. Metronidazole is recommended for treatment of acute appendicitis complicated by peritonitis.
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PMID:[Metronidazole in the complex treatment of peritonitis of appendicular etiology in children]. 333 Jun 33

Metronidazole (trichopol) included in the complex of curative measures in acute appendicitis complicated by local or diffuse peritonitis resulted in a substantially decreased amount of pyo-inflammatory complications after appendectomy and shorter time of staying at the hospital.
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PMID:[Treatment of complicated appendicitis]. 649 49

Ticarcillin was compared with metronidazole in the prevention of wound infection after appendicectomy. Two hundred nine patients with a diagnosis of acute appendicitis were admitted to a prospective, randomized study and received 500 mg of metronidazole or 5 g of ticarcillin intravenously before operation. Those patients with gangrenous or perforated appendices received two additional doses of the trial drug at 8 hourly intervals. The overall incidence of wound infections in both the metronidazole and the ticarcillin groups was 9 percent. There were no intraabdominal abscesses. Metronidazole abolished anaerobic wound infections. All the early wound infections (between 2 and 4 days after operation) occurred in patients with gangrenous or perforated appendices. We conclude that ticarcillin is as effective as metronidazole in the prevention of wound infection after appendicectomy, but in high-risk patients, (those with gangrenous or perforated appendices) longer courses of antibiotics should be employed.
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PMID:Metronidazole and ticarcillin in the prevention of sepsis after appendicectomy. 661 25

Patterns of antimicrobial susceptibility were determined for 155 clinical isolates of the Bacteroides fragilis group from patients with acute appendicitis in Bali, Indonesia. The transfer of drug resistance was also studied, and plasmid analyses were undertaken. Metronidazole and chloramphenicol were the most active drugs against these isolates (resistance rate, < or = 0.6%). Among the beta-lactam drugs, cefoxitin was the most active (resistance rate, 2%). Rates of resistance to tetracycline were high (16%). Resistance to clindamycin (rate, 10%) increased during the 2-year study period. Except in the case of beta-lactam agents, overall susceptibility patterns were comparable to those reported from other countries. Tetracycline resistance was more frequently transferred after tetracycline induction than without such induction (P < .05, chi 2 test). Resistance to tetracycline and clindamycin was co-transferred by five of 12 donor strains. In one of these five strains, transferability was constitutive, with a high transfer frequency (10(-5) per input donor). Plasmid analysis indicated that the transfer of resistance to tetracycline and clindamycin among the strains studied was not plasmid mediated.
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PMID:Antimicrobial susceptibility patterns and resistance transferability among Bacteroides fragilis group isolates from patients with appendicitis in Bali, Indonesia. 851 66

A three year prospective randomised study was undertaken to study the efficacy of three regimens of antimicrobial drug combinations in reducing postoperative wound sepsis in acute appendicitis. Group A--Metronidazole and gentamicin; Group B--Metronidazole and ciprofloxacin; Group C--Metronidazole and cefotaxime. Randomization was done by drawing from a set of sealed envelopes. Antibiotics were started preoperatively once a presumptive diagnosis of appendicitis was made, provided there was no history of prior antibiotic usage. For simple appendicitis (normal or inflamed) two more doses were given postoperatively. For complicated appendicitis, duration of antibiotic treatment was four days postoperatively. All antibiotics were given intravenously to avoid variations in bioavailability. Wound was inspected daily till discharge and at 30 days post operatively or earlier if the patient had symptoms of wound infection. A total of 128 patients completed the study. Eighty nine were simple appendicitis while the rest were complicated. Twenty one developed wound infection. Out of 21, 13 occurred in group A, 5 in group B and 3 in group C. Individually, the difference in infection rates between group A and group C patients with simple appendicitis was statistically significant. Infection rates in all other groups were not statistically different. Cefotaxime and metronidazole combination had the lowest wound infection rate. Hence it is recommended for antibiotic prophylaxis.
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PMID:A trial of various regimens of antibiotics in acute appendicitis. 961 3

A total of 249 patients, undergoing appendectomy for acute appendicitis, were prospectively randomized into two groups. Group I, comprising 132 patients, received sterile normal saline irrigation to the surgical wound at closure. Alternatively, Group II included 117 patients, who received intraoperative topical ampicillin irrigation of the wound. Both groups were comparable with regard to age, sex, duration of symptoms, and severity of appendicitis. All patients additionally received preoperative systemic gentamicin and Flagyl. Wound infection occurred in 5.3% of Group I compared to only 0.9% of Group II (P<0.05). The reduction in infection rate was significant (P<0.05) in histologically proven appendicitis. We conclude that the addition of intraoperative topical ampicillin to systemic gentamicin and Flagyl augments prophylaxis against wound infection in acute appendicitis.
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PMID:Topical ampicillin for prophylaxis against wound infection in acute appendicitis. 1758 99

Appendectomy is the standard treatment for acute appendicitis. Since the 1990s, antibiotic therapy has sometimes been proposed as an alternative to immediate appendectomy. How effective are antibiotics in adults with uncomplicated acute appendicitis, and what is the risk of complications? To answer these questions, we conducted a review of the literature using the standard Prescrire methodology. A systematic review with meta-analysis included four randomised trials of antibiotics versus immediate appendectomy, in 900 patients hospitalised with uncomplicated appendicitis. The studies included only patients with few severe symptoms, thus undermining the strength of the results. Antibiotic therapy was usually administered intravenously first, then orally. The antibiotics used were amoxicillin + clavulanic acid, cefotaxime, or a fluoroquinolone. Metronidazole or tinidazole was often added. The total duration of antibiotic treatment was 8 to 15 days. The overall incidence of complications of appendicitis (perforation, peritonitis and surgical wound infections) was 25% in the immediate appendectomy group versus 18% in the antibiotic group. The frequency of perforations and peritonitis did not differ between the groups. All symptoms of appendicitis disappeared, without relapse or rehospitalisation during the first month, in 78% of patients in the antibiotic group. After one year of follow-up, 63% of patients treated with antibiotics were asymptomatic and had no complications or recurrences. In another systematic review of five randomised trials, outcome at one year was optimal in 73% of patients treated with antibiotics alone versus 97% of patients who had immediate appendectomy. In practice, in early 2014, appendectomy remains the first-line treatment for uncomplicated acute appendicitis. In some still poorly characterised patients, the harm-benefit balance of antibiotic therapy is probably better than that of immediate appendectomy. When informed of the risks, some patients are likely to choose antibiotic therapy.
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PMID:Antibiotic therapy for acute appendicitis in adults. Fewer immediate complications than with surgery, but more subsequent failures. 2512 Nov 54

We reported a case of amoebic liver abscess (ALA) in a 6-year-old Malaysian boy who presented with fever, lethargy, diarrhoea and right hypochondriac pain. On admission he was diagnosed with perforated acute appendicitis and a laparotomy was done. After surgery he developed acute respiratory distress. Ultrasonography, chest X-Ray and CT scan revealed two ALAs in the posterior segment of right lobe of liver, pleural effusion and collapsed consolidation of lungs bilaterally. Percutaneous liver abscesses drainage was done and intravenous Metronidazole was started. PCR carried out on the pus from the abscess was positive for Entamoeba histolytica. Patient however succumbed to the infection one week after admission.
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PMID:Fatal case of amoebic liver abscess in a child. 2652 7