Aim: To compare the efficacy of rectal and intravenous metronidazole in the prevention of anaerobic wound infections after appendicectomy.
Patients and methods: One hundred patients subjected to appendicectomy were randomly assigned to receive, 2 hours before operation, gentamycin 80 mg i.v. and metronidazole 1 g i.v. or the same amount of gentamycin and 1 g of metronidazole as a suppository. Surgical wounds were observed for infections until the tenth day of the postoperative period.
Results: Seven of 45 patients receiving intravenous metronidazole and six of 44 receiving the drug as suppositories had wound infection. The frequency of infections was higher among patients with gangrenous or perforated appendices. They were detected at the fifth postoperative day in 8 patients and the most frequently isolated bacteria were E coli and S aureus.
Conclusions: Rectal metronidazole is equally effective than intravenous metronidazole in the prevention of would infections after appendicectomy.