Metronidazole and appendicitis. Can a preoperative prophylaxis be changed to a peroperative treatment in high risk patients?

Sixty-four consecutive patients appendicectomized for perforated appendicitis were studied retrospectively to assess the effect of peroperative metronidazolee on postoperative infections. All patients were given antibiotics against aerobic organism. The infection rate in patients receiving metronidazol peroperative was 3%. It is concluded that the effect of peroperative administrated metronidazole in prevention of postoperative infections after perforated appendicitis is as good as previously demonstrated for preoperative administrated. Consequently metronidazole treatment can be restricted to peroperative proven high risk patients with perforated and perhaps gangrenous appendicitis.