ANTIBIOTIC USE IN PREVENTION OF ANAL FISTULAS FOLLOWING INCISION AND DRAINAGE OF ANORECTAL ABSCESS: A SYSTEMATIC REVIEW
DOI:
https://doi.org/10.53555/nnmhs.v9i1.1527Keywords:
Antibiotic, Anorectal Abscesse, Drainage, Incision, PreventionAbstract
Perianal abscess is a condition that arises with an extraordinarily high frequency in general surgery. Despite the fact that the majority of patients reported here suffered from a relatively simple and uncomplicated disease, as estimated retrospectively, the data presented suggest that there is an alarmingly high rate of acquired drug resistance in bacteria detected in purulence swabs from perianal abscesses obtained during surgical drainage procedures in approximately 27% of all patients, especially in patients with a more severe disease. This rate is especially high in perianal abscess patients. The primary objective of surgical treatment for anal fistulain-ano is to obliterate the internal fistulous opening and any associated epithelialized tracks while retaining the anal sphincter's function. Due to the fact that no single surgery is appropriate for the treatment of all fistulas, treatment must be directed by the fistula's etiology and architecture, the degree of symptoms, the patient's comorbidities, and the surgeon's experience. One must consider the trade-off between sphincter division extent, surgical healing rates, and functional compromise. Following incision and drainage of anorectal abscesses, antibiotic therapy is related with a decreased likelihood of fistula formation. An empiric 5-10-day course of antibiotics following surgical drainage may prevent fistula formation in otherwise healthy patients, notwithstanding the low quality of the data.
References
Lohsiriwat V, Yodying H, Lohsiriwat D. Incidence and factors influencing the development of fistula-in-ano after incision and drainage of perianal abscesses. Med J Med Assoc Thail. 2010;93(1):61.
Sahnan K, Adegbola SO, Tozer PJ, Watfah J, Phillips RKS. Perianal abscess. Bmj. 2017;356.
Niyogi A, Agarwal T, Broadhurst J, Abel RM. Management of perianal abscess and fistula-in-ano in children. Eur J Pediatr Surg. 2010;20(01):35–9.
Adamo K, Sandblom G, Brännström F, Strigård K. Prevalence and recurrence rate of perianal abscess—a population-based study, Sweden 1997–2009. Int J Colorectal Dis. 2016;31:669–73.
Pearce L, Newton K, Smith SR, Barrow P, Smith J, Hancock L, et al. Multicentre observational study of outcomes after drainage of acute perianal abscess. J Br Surg. 2016;103(8):1063–8.
Sigmon DF, Emmanuel B, Tuma F. Perianal abscess. 2017;
Amato A, Bottini C, De Nardi P, Giamundo P, Lauretta A, Realis Luc A, et al. Evaluation and management of perianal abscess and anal fistula: SICCR position statement. Tech Coloproctol. 2020;24:127–43.
Juth Karlsson A, Salö M, Stenström P. Outcomes of various interventions for first-time perianal abscesses in children. Biomed Res Int. 2016;2016.
Smith SR, Newton K, Smith JA, Dumville JC, Iheozor?Ejiofor Z, Pearce LE, et al. Internal dressings for healing perianal abscess cavities. Cochrane Database Syst Rev. 2016;(8).
Ghahramani L, Minaie MR, Arasteh P, Hosseini SV, Izadpanah A, Bananzadeh AM, et al. Antibiotic therapy for prevention of fistula in-ano after incision and drainage of simple perianal abscess: a randomized single blind clinical trial. Surgery. 2017;162(5):1017–25.
Mohamad Hasan R. Postoperative empirical antibiotic use for uncomplicated perianal abscess and fistula. Iran J Color Res. 2017;5(1–2):1–8.
Seow?En I, Ngu J. Routine operative swab cultures and post?operative antibiotic use for uncomplicated perianal abscesses are unnecessary. ANZ J Surg. 2017;87(5):356–9.
Bender F, Eckerth L, Fritzenwanker M, Liese J, Askevold I, Imirzalioglu C, et al. Drug resistant bacteria in perianal abscesses are frequent and relevant. Sci Rep [Internet]. 2022;12(1):14866. Available from: https://doi.org/10.1038/s41598-022-19123-6
Vogel JD, Johnson EK, Morris AM, Paquette IM, Saclarides TJ, Feingold DL, et al. Clinical practice guideline for the management of anorectal abscess, fistula-in-ano, and rectovaginal fistula. Dis Colon Rectum. 2016;59(12):1117–33.
Rasane RK, Centeno Coleoglou AA, Horn CB, Torres MB, Nohra E, Zhang Q, et al. Inadequate antibiotic therapy results in higher recurrence rate after drainage of complicated peri-rectal abscess. Surg Infect (Larchmt). 2020;21(10):823–7.
Beck DE, Beck DE. Handbook of colorectal surgery. Marcel Dekker New York, NY; 2003.
Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, et al. Prevention of infective endocarditis: guidelines from the American heart association: a guideline from the American heart association rheumatic fever, endocarditis, and Kawasaki disease committee, council on cardiovascular disease in the young, and the council on clinical cardiology, council on cardiovascular surgery and anesthesia, and the quality of care and outcomes research interdisciplinary working group. Circulation. 2007;116(15):1736–54.
Serour F, Somekh E, Gorenstein A. Perianal abscess and fistula-in-ano in infants: a different entity? Dis colon rectum. 2005;48:359–64.
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Journal of Advance Research in Medical & Health Science
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Licensing
Ninety Nine Publication publishes articles under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This licensing allows for any use of the work, provided the original author(s) and source are credited, thereby facilitating the free exchange and use of research for the advancement of knowledge.
Detailed Licensing Terms
Attribution (BY): Users must give appropriate credit, provide a link to the license, and indicate if changes were made. Users may do so in any reasonable manner, but not in any way that suggests the licensor endorses them or their use.
No Additional Restrictions: Users may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
