Appendicial Peritonitis in Children: Is the Practice of Routine Intra-operative Peritoneal Cultures Justified?

Abstract

Results of intra-operative peritoneal culture swabs were reviewed in 47 children with complicated appendicitis in an attempt to find their correlation with the perioperative antibiotics used empirically. The culture results were positive in 44 patients. E Coli (83%) and Bacteroides spp. (72%) were the most common organisms isolated, followed by Enterococci, Pseudomonas and Klebsiella. The empirical antibiotic therapy (combination of Ampicillin, Gentamycin and Metronidazole followed by single agent, Augmentin) was found to be effective in almost all the patients, as indicated by the sensitivity reports and therapeutic response. The antibiotic therapy was not changed in any patient in the postoperative period. As the bacterial flora of the complicated appendicitis is well documented and the combination antibiotic therapy provides a comprehensive cover for these microorganisms, it is fell that currently, the practice of routine use of peritoneal cultures is not justified and cost effective.