Preoperative Versus Postoperative Antibiotic Regimens in Reducing Surgical Site Infections Following Appendectomy in Tribal Populations of Western Maharashtra in a Tertiary Care Hospital

Background: Surgical site infections (SSIs) are common complications following appendectomy, contributing to prolonged hospital stays, increased healthcare costs, and patient morbidity. Objective: This study compares the effectiveness of preoperative versus postoperative antibiotic regimens in reducing SSIs following appendectomy. Methods: A total of 255 patients undergoing appendectomy were randomized into three groups: preoperative antibiotic group (n = 85), postoperative antibiotic group (n = 85), and combined antibiotic group (n = 85). All patients received a standard antibiotic regimen of ceftriaxone 2g intravenously. The primary outcome was the incidence of SSIs, and secondary outcomes included length of hospital stay, readmission rates, and antibiotic-related adverse effects. Results: The overall SSI rate was 12%, with 9% of patients in the preoperative antibiotic group, 15% in the postoperative group, and 10% in the combined antibiotic group developing SSIs. No significant differences were found between the preoperative and postoperative antibiotic groups (p = 0.13). However, the combined antibiotic regimen showed a slightly lower SSI rate compared to the postoperative group (p = 0.08). Patients with SSIs had a significantly longer hospital stay (7.1 ± 2.3 days) compared to those without SSIs (3.1 ± 1.1 days, p < 0.01). Readmission rates were low across all groups (3% overall), primarily due to SSIs. Adverse effects from antibiotics were minimal and similar across all groups. Conclusion: Preoperative antibiotic prophylaxis is effective in reducing SSIs following appendectomy, with no significant advantage from postoperative antibiotics in uncomplicated cases.