COMPARISON OF SHORT-TERM AND LONG-TERM COURSE OF ANTIBACTERIAL THERAPY FOR INTRA-ABDOMINAL INFECTION CAUSED BY ACUTE GANGRENOUS APPENDICITIS

Intra-abdominal infection and its complications is still remaining a fairly common and urgent global problem. Currently, there are a large number of publications providing guidelines and recommendations for the treatment of infections caused by a certain type of causative agents. However, the appropriate duration of antibiotic therapy is among the most controversial issues. Majority of clinicians tend to prescribe antibiotic therapy until all signs of inflammation disappear, usually for 7-14 days. But, in 1994, Schein M., and co-authors suggested that with adequate treatment of the focus of intra-abdominal infection, the duration of antibiotic therapy can be reduced to 3-4 days that in turn will reduce the resistance to antibacterial drugs. The aim of this study was to investigate the possibility in reducing antibiotic therapy length for patients with intra-abdominal infection caused by acute gangrenous appendicitis. The study included 32 patients aged 18 - 65 years, who were operated on for acute gangrenous appendicitis at the same day when admitted to the hospital at the surgical department of the 3rd Municipal Clinical Hospital of Poltava. The patients were divided into two groups. The first (study) group included 16 patients who received antibiotic therapy within minimum 3 days until the normalization of the leukocytosis and body temperature. The second (control) group included 16 patients who continued to receive antibiotic therapy for at least 2 days following the normalization of these criteria. Based on the results obtained in studying the effect of the length of antibiotic therapy course on intra-abdominal infection in the patients with acute gangrenous appendicitis during the postoperative period, we revealed the duration of antibiotic therapy for 3 ± 0.25 days showed similar results compared to the results of traditional and longer antibiotic therapy. The comparable values included periods of recovery and discharge following the surgery, the incidence of complications in the early and remote postoperative period. Our data confirm the concept that adequate surgical treatment of the infection focus in the abdominal cavity results in the reduction of antibiotic therapy length for several days after the operation without the risk of developing postoperative complications and recurrence of the infectious process.