PROPHYLACTIC ANTIBIOTICS IN UNCOMPLICATED APPENDICITIS DURING CHILDHOOD - A PROSPECTIVE RANDOMIZED STUDY

544 children operated upon for uncomplicated appendicitis were randomi sed into three groups. Group I received no antibiotics, patients in Gr oup II were administered one single preoperative dose of metronidazole (20 mg/kg) and patients in Group III received both metronidazole (20 mg/kg) and cefuroxime (50 mg/kg) in a single preoperative dose. The ra te of infectious complications in Group I was 6.3% but only 2.1 and 2. 3 in Groups II and III, respectively. Among patients with a normal app endix or patients with simple appendicitis there was no difference in the rate of postoperative infections between the three different group s. However, in patients with gangrenous appendicitis the rate of posto perative infections was significantly lower in the two groups who rece ived preoperative antibiotics (1.8% and 3.0% respectively) than in the group receiving no prophylactic antibiotics (infection rate 14%). It is concluded that a single preoperative dose of metronidazole signific antly decreases the rate of postoperative infectious complications in children with appendicitis. No further improvement could be demonstrat ed if cefuroxime against aerobic organisms was added.