Demonstration of antibiotic activity in experimental appendicitis model

Appendicitis has a very important place in the practice of Pediatric Surgery. The fundamental treatment of appendicitis is surgery. However, antibiotics treatment without surgery for appendicitis came up recently. Appendicitis increases acute phase reactants due to inflammation. Acute phase reactants are decreased due to surgery or antibiotic treatment. In this study, 68 In our study; When group 2 and group 3 were statistically analyzed, there was no significant difference between procalcitonin values and leukocyte values. There was a significant difference in CRP values between the two groups on Day 0, Day 2 and Day 7. The antibiotic treatment causes to decrease in CRP levels in two groups. This situation shows inflammations have decreased. As a result, antibiotic treatment reduces inflammation, the most significant sign of which is that the CRP values are significantly lower on days 2 and 7 than in the disease group. But there was no statistically signicant difference in both groups. Leukocyte levels increased in group 2 and group 3 on the second day. For both groups, leukocytes were degenerated on the 7th day. However, antibiotics have been found to be more appropriate for leukocytes in the given group. This decline is statistically meaningless. At last antibotic treatmant decrease inflamation and lowered CRP values on days 2 and 7 when compared to the disease group was the most important indicator of this condition. When Group 2 and Group 4 were statistically analyzed, no significant difference was observed between Procalcitonin values and leukocyte values. There was significant difference in CRP values between the two groups on Day 0, Day 2 and Day 7. When group 3 and group 4 were statistically analyzed, there was no significant difference between procalcitonin values and leukocyte values. There was a significant difference in CRP values between the two groups on Day 0 and Day 2. There was no significant decrease in leukocyte counts in group 3, treated with antibiotics, while no decrease is observed in the group treated with the appendectomy. Nevertheless, Antibiotic therapy ensures that late period CRP levels are as low as in surgery. When pathological examinations are analyzed; There was a significant difference between groups in terms of inflammation of the mucosa, submucosa, and subserosal parts (chisquare 0.01). TNF alpha immunohistopathological examination showed 69 significant difference among the 4 groups (chi-square 0.043). IL - 6 immunohistopathological examination showed a significant difference between the 4 groups (chi-square 0.014). IL6 immunhistokimyasal incelemede; Grup 3 ve Grup 4' de yani antibiyotik tedavisi alan ve apendektomi yapılan grupta enflamasyon azalmıştır. For the IL6 immunohistochemical examination; In Group 3 and Group 4, ie, the groups receiving antibiotic treatment and appendectomy respectively, inflammation decreased. Significant differences were observed between groups 2 and 3 in terms of immunohistochemical TNF alpha and IL6 values (Chi-square 0.031 - 0.018). Antibiotic therapy has reduced inflammation. There was a significant difference in inflammation in terms of TNF and IL6 between groups 2 and 4 [(chi-square (0,031-0,01)]. Appendectomy has decreased the inflammation. When the biochemical study is considered as a monitoring criterion, we conclude that the values of procalcitonin have no meaning in the appendicitis model we have created. Although antibiotic therapy decreases the values of procalcitonin in the late period, the values of procalcitonin vary and lower values do not correlate with the presence of inflammation or the degree of inflammation. .Appendectomy seems to have not affected leukocyte levels. Leukocyte levels in the antibiotic group may be lower than in the appendectomy group, which may indicate the efficacy of antibiotic therapy. . In this model, appendicitis elevates CRP in the late period and surgery significantly inhibits this elevation. Antibiotic therapy also significantly reduces CRP according to the disease group and is as effective as surgery at the same time. Thus, CRP may be a monitoring criterion for antibiotic treatment, especially since the second day. . However, antibiotic therapy did not affect pathological inflammation positively. On the other hand, inflammation was significantly reduced when TNF and IL6, which are indicators of mediator level of inflammation, are observed. Therefore, in general terms, antibiotic treatment reduces pathological inflammation. Keywords:Apandiscitis, rat, experimental, non surgical therapy, antibiotic therapy, non complicated