A COMPARATIVE STUDY ON ROLE OF METRONIDAZOLE IN SURGICAL MANAGEMENT OF ACUTE SIMPLE VERSUS ACUTE COMPLICATED APPENDICITIS

Background: Although appendicectomy remains the standard and classical treatment for acute appendicitis, Metronidazole plays an important role in addition to antibiotics in controlling the infection was tested as an effective protocol. But comparison of its role in acute simple versus acute complicated Appendicitis was attempted in this study. Aim of the study: To assess the effectiveness and outcomes of Metronidazole as an adjuvant to antibiotic treatment for acute simple and acute complicated appendicitis. Materials: This was a prospective, controlled, non-randomized study involving 76 patients aged between 18 and 54 years. All clinically diagnosed with acute and acute complicated appendicitis. These patients were treated with appendicectomy and Metronidazole and  antibiotic therapy, which included Metronidazole 500 mg IV thrice daily in addition to Ceftriaxone 1 gram twice daily administered three times daily for one week. Once the clinical improvement was observed, the treatment was switched to oral Metronidazole 200 mg thrice daily along with Cefixime 200 mg twice daily for 5 to 7 days. All the data related to the patients was analyzed using suitable statistical methods. Results: Antibiotic treatment with Metronidazole was successful and feasible in 68/76 (89.74%) patients. In Group ‘A’ 22/38 patients (57.89%) sought medical attention within 24 hours of symptom onset, 10/38 patients (26.31%) presented between 24 and 48 hours. In group B 16/38 patients (42.10%) sought medical attention within 24 hours of symptom onset, 10/38 patients (26.31%) presented between 24 and 48 hours. There was statistical significance on Chi square test on the time of reporting to EMD and Alvarado score with p value 0.001 (p significant at less than 0.05). Conclusion: Metronidazole for acute simple and acute complicated Appendicitis was safe, feasible, and effective option.