OBJECTIVE: To compare the efficacy of short-course versus longcourse antibiotic therapy among patients undergoing appendectomy for complicated appendicitis. METHODS: The authors conducted an electronic search of PubMed, Cochrane Library, and EBSCOHost for studies from 2000 to January, 2000 to September, 2018 comparing short-course versus long-course antibiotic therapy in adults undergoing appendectomy for complicated appendicitis. The outcomes considered were the incidence of superficial surgical site infection and intra-abdominal abscess, and duration of hospital stay. Meta-analysis was performed using Review Manager software. RESULTS: A total of 360 patients in two studies were analyzed. Superficial surgical site infection was identified in 5 out of 123 patients in the short-course antibiotic group (4%), and 5 out of 237 patients in the long-course antibiotic group (2.1%) (95% CI 0.38, 5.51, p=0.58). There was a decrease in the incidence of intra-abdominal abscess in the short-course antibiotic group (6.5%), but the difference was not statistically significant (95% CI 0.32, 1.77, p=0.52). The duration of hospital stay was significantly less in the short-course antibiotic group (3.95 days) compared to the long-course antibiotic group (4.6 days) (95% CI -0.66, -0.21; p<0.001). CONCLUSION No difference between the <5-day and ≥5-day antibiotic course in terms of surgical site infection and intra-abdominal abscess was detected. However, the hospital stay of the <5-day group was shorter.
Appendectomy

A retrospective study was undertaken on 103 diabetic patients with foot ulcers who were confined at the UERM Memorial Medical Center from January 1988 to June 1991 with the aim of determining clinical and laboratory criteria which are useful in predicting the need for amputation. Patients were divided into two groups according to treatment modality: Group A, debridement (58 patients) and Group B, amputation (45 patients). Nineteen variables chosen from the patients demographic characteristics, clinical histories and evaluation, and laboratory work-up were reviewed, evaluated, and processed using the normal approximation statistics and logistic regression to obtain a resulting set of predictors. Osteomyelitis, leukocytosis, decreased or absent peripheral pulses, systolic hypertension and smoking history were the five variables found to be significantly associated with the need for an ablative surgical procedure. These quantitated variables are entered into the computed logistic equation to obtain a score which will enable us to determine the appropriate therapeutic intervention tailored to the individuals risk status. If the computed value is greater than or equal to 7, amputation should be the course of action. If the computed value is less than or equal to 3, conservative treatment is advocated. If the value obtained is between 3 and 7, the patient is considered a borderline case and proper management will have to depend on the judgment of the surgeon. With this scoring system as a guide, a definitive operation can be performed at an early stage to prevent the burden of multiple operations and the accompanying high morbidity and post-operative mortality rates.

Human ; Male ; Female ; Foot ; Diabetes Mellitus ; Diabetic Foot ; Amputation