A Danish multicenter study: Cefoxitin versus ampicillin + metronidazole in perforated appendicitis

Abstract
A prospective controlled randomized-block multicenter study was carried out in 209 patients undergoing surgery for perforated or ruptured appendicitis. The patients received either cefoxitin or ampicillin + metronidazole for 5 days. The treatment was started peroperatively. In both groups wound infections were found to be less than 10 per cent and no difference could be demonstrated. However cefoxitin was significantly superior to ampicillin + metronidazole in preventing intra-abdominal abscesses (P < 0.05). Cefoxitin offers a single drug treatment that adequately reduces postoperative infectious complications in patients undergoing surgery for perforated or ruptured appendicitis.