Laparoscopic Antibiotic Lavage to Prevent Intra-abdominal Abscess Formation in Complicated Appendicitis

Exclusion Criteria

• •Age under 8 years;
• •Not able to give informed consent (language barrier, legally incapable)
• •Any contraindication for the use of the study medication:
• •* Hypersensitivity to clindamycin or to any of the excipients benzyl alcohol, sodium edetate, water, or to lincomycin;
• •* Hypersensitivity to gentamicin or to sodium metabisulfite: particularly in asthmatic patients, this may trigger bronchospasms and anaphylactic shock or to any of the excipients: disodium edetate, sodium hydroxide, sodium metabisulfite (E223), water for injections;
• •Severe sepsis defined as sepsis-induced tissue hypoperfusion or organ dysfunction that includes any of the following thought to be caused by the infection:
• •* Sepsis-induced hypotension
• •* Lactate above upper limits laboratory normal
• •* Urine output \<0.5 mL/kg/h for more than 2h despite adequate fluid resuscitation
• •* Acute lung injury with PaO2/FiO2 \<250 in the absence of pneumonia as infection source
• •* Acute lung injury with PaO2/FiO2 \<200 in the presence of pneumonia as infection source
• •* Creatinine \>2.0 mg/dL (176.8 μmol/L)
• •* Bilirubin \>2mg/dL (34.2 μmol/L)
• •* Platelet count \< 100,000 μL
• •* Coagulopathy (international normalized ratio (INR) \> 1.5);
• •ASA IV score;
• •Known malignancy;
• •Renal dysfunction (i.e. eGFR ≤ 60);
• •Immunocompromised patients (i.e. hematological malignancies, HIV/AIDS, bone marrow transplantation, splenectomy, genetic disorders such as severe combined immunodeficiency, chemotherapy, dialysis, solid organ transplant, and immunosuppressant use (such as corticosteroids in patients with rheumatoid arthritis));
• •Pregnancy;
• •Known allergies to either gentamicin or clindamycin;
• •Known colonization of bacteria resistant to either gentamicin or clindamycin;