EMPIRICAL ANTIBIOTIC TREATMENT OF COMPLICATED APPENDICITIS

Masteria Choirunnisa, Bambang Arianto*

Background: There are many cases of complicated appendicitis, and there is a risk of life-threatening if not treated properly. The first line of treatment for complicated appendicitis is surgery and administration of appropriate empiric antibiotics. Method: This study employs a retrospective design with a cross-sectional approach. Sampling was conducted using consecutive sampling. The data taken comes from secondary data, namely the results of culture and sensitivity tests of complicated appendicitis cases in the microbiology department of the Haji Hospital, Surabaya, in 2021-2023. Results: Data collected from the microbiology section of the Haji Hospital, East Java Province, 57 cases of complicated appendicitis were obtained, which underwent aerobic culture, and the results of germ growth. Anaerobic culture examination was not conducted because the necessary facilities did not yet exist. The distribution of male patients was 64.91%, and that of female patients was 35.09%. From the culture results, 100% of the isolates were gram-negative aerobic bacteria. The examination results were based on the types of bacteria: Escherichia coli ESBL (43.86%), Escherichia coli (42.11%), and Klebsiella pneumoniae (7.02%)—as determined by the results of the antibiotic sensitivity examination. Escherichia coli ESBL is sensitive to meropenem, amikacin, and cefepime. Escherichia coli is sensitive to ceftriaxon, meropenem, amikacin, and cefepime. Conclusion: The dominant microbe that causes complicated appendicitis is Escherichia coli ESBL, which is resistant to ceftriaxone. The second most common bacteria is Escherichia coli, which remains sensitive to ceftriaxone. Careful consideration is needed for clinicians to determine the type of empirical antibiotic based on the patient's clinical findings.