<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2444-054X</journal-id>
<journal-title><![CDATA[Cirugía y cirujanos]]></journal-title>
<abbrev-journal-title><![CDATA[Cir. cir.]]></abbrev-journal-title>
<issn>2444-054X</issn>
<publisher>
<publisher-name><![CDATA[Academia Mexicana de Cirugía A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2444-054X2020000300297</article-id>
<article-id pub-id-type="doi">10.24875/ciru.19001275</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Carbapenems versus ciprofloxacin/metronidazole for decreasing complications and hospital stay following complicated acute appendicitis surgery: A prospective cohort in an Ecuadorian population]]></article-title>
<article-title xml:lang="es"><![CDATA[Carbapenémicos vs. ciprofloxacino/metronidazol en la disminución de las complicaciones y de la estancia hospitalaria tras cirugía por apendicitis aguda complicada: cohorte prospectiva en una población ecuatoriana]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bunces-Orellana]]></surname>
<given-names><![CDATA[Orlando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arevalo-Vidal]]></surname>
<given-names><![CDATA[Eduardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bustos-Galarza]]></surname>
<given-names><![CDATA[Karla]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferrín-Viteri]]></surname>
<given-names><![CDATA[Mario]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Oleas]]></surname>
<given-names><![CDATA[Roberto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Baquerizo-Burgos]]></surname>
<given-names><![CDATA[Jorge]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Puga-Tejada]]></surname>
<given-names><![CDATA[Miguel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital General del Norte de Guayaquil Los Ceibos Servicio de Cirugía General ]]></institution>
<addr-line><![CDATA[Guayaquil ]]></addr-line>
<country>Ecuador</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Teodoro Maldonado Carbo Servicio de Cirugía General ]]></institution>
<addr-line><![CDATA[Guayaquil ]]></addr-line>
<country>Ecuador</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Luis Vernaza Servicio de Terapia Intensiva ]]></institution>
<addr-line><![CDATA[Guayaquil ]]></addr-line>
<country>Ecuador</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Instituto Ecuatoriano de Enfermedades Digestivas  ]]></institution>
<addr-line><![CDATA[Guayaquil ]]></addr-line>
<country>Ecuador</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2020</year>
</pub-date>
<volume>88</volume>
<numero>3</numero>
<fpage>297</fpage>
<lpage>305</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2444-054X2020000300297&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2444-054X2020000300297&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2444-054X2020000300297&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background: After appendectomy due to complicated acute appendicitis (CAA), there are some alternatives as antibiotic scheme: ciprofloxacin/metronidazole; as well as monoscheme based on carbapenems: ertapenem, meropenem, and imipenem.  Aim: This study aims to prove the efficacy of carbapenems versus ciprofloxacin/metronidazole in CAA post-operative management in terms of preventing complications during post-operative period and decreasing hospital stay.  Materials and methods: This was an observational, analytical, longitudinal, and prospective cohort study (March 2014-November 2016). Patients were classified into two groups, according to the prescribed antibiotic scheme: some carbapenems or ciprofloxacin/metronidazole.  Results: Ninety-eight patients were enrolled. There was an requirement for antibiotic therapy rotation only in the ciprofloxacin/metronidazole (7/49, 14.3%; p = 0.004). Carbapenems reached a mean hospital stay of 4.45 days, in contrast with ciprofloxacin/metronidazole, 8.29 days (p = 0.020). In post-surgical follow-up, there were more cases of curative resolution in the group in the carbapenems group (35/49 vs. 15/49 p &lt; 0.001) as well as a greater number of cases with some late infection in the ciprofloxacin/metronidazole group (1/49 vs. 10/49, p = 0.010).  Conclusion: In the post-operative management of CAA, carbapenems represent an important indication to be considered as first-line antibiotic therapy.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Antecedentes: Tras la cirugía por apendicitis aguda complicada existen varias alternativas de esquema antibiótico, entre las que destacan ciprofloxacino/metronidazol, o bien monoterapia con algún carbapenémico, como ertapenem, meropenem e imipenem.  Objetivo: Determinar la eficacia de los carbapenémicos en comparación con ciprofloxacino/metronidazol en el manejo posquirúrgico de la apendicitis aguda complicada, en términos de prevención de complicaciones durante el posoperatorio y de reducción de la estancia hospitalaria.  Método: Estudio observacional, analítico, longitudinal, prospectivo y de cohorte, de marzo de 2014 a noviembre de 2016. Los pacientes fueron clasificados en dos grupos según el esquema antibiótico prescrito: un carbapenémico o ciprofloxacino/metronidazol.  Resultados: Se seleccionaron 98 pacientes. Solo hubo necesidad de rotación de antibiótico en el grupo de ciprofloxacino/metronidazol (7 de 49, 14.3%; p = 0.004). En el grupo de carbapenémico, la media de estancia hospitalaria fue de 4.45 días, y en el grupo de ciprofloxacino/metronidazol fue de 8.29 días (p = 0.020). En el seguimiento posquirúrgico hubo más casos de resolución curativa en el grupo de carbapenémico (35 de 49 vs. 15 de 49; p &lt; 0.001), así como un mayor número de casos con alguna infección tardía en el grupo de ciprofloxacino/metronidazol (1 de 49 vs. 10 de 49; p &lt; 0.001).  Conclusión: En el manejo posquirúrgico de la apendicitis aguda complicada, los carbapenémicos representan una importante indicación que debe considerarse como antibioticoterapia de primera línea.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Appendicitis]]></kwd>
<kwd lng="en"><![CDATA[Carbapenems]]></kwd>
<kwd lng="en"><![CDATA[Ciprofloxacin]]></kwd>
<kwd lng="en"><![CDATA[Metronidazole]]></kwd>
<kwd lng="en"><![CDATA[Post-operative period]]></kwd>
<kwd lng="es"><![CDATA[Apendicitis]]></kwd>
<kwd lng="es"><![CDATA[Carbapenémicos]]></kwd>
<kwd lng="es"><![CDATA[Ciprofloxacino]]></kwd>
<kwd lng="es"><![CDATA[Metronidazol]]></kwd>
<kwd lng="es"><![CDATA[Periodo posoperatorio]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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