THE PREVENTION OF POSTAPPENDICECTOMY SEPSIS BY METRONIDAZOLE AND COTRIMOXAZOLE: A CONTROLLED DOUBLE BLIND TRIAL

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Abstract
A double-blind, randomized controlled trial was carried out in University Hospital, Kuala Lumpur [Malaysia] to study the effect of metronidazole and cotrimoxazole on the incidence of wound infection following appendectomy from Nov. 1978 to Jan. 1980. Patients were allocated at random into 1 of 4 groups: cotrimoxazole injection and placebo suppository, metronidazole suppository and cotrimoxazole injection, metronidazole suppository and placebo injection, or placebo suppository and placebo injection. Treatment was started 30 min before operation and continued for 72 h. All patients were followed up for 2 wk and thereafter for 1 mo.; 283 patients were accepted into the study. Sepsis rates were 27% for the untreated group, 9% for the group receiving metronidazole only, 8% for the group receiving cotrimoxazole injection only and 2.7% for the group receiving both drugs. Thus, a combination of metronidazole and cotrimoxazole is a highly effective regime for prophylaxis against wound infection following appendectomy.