EP 600 Evaluating the Role of Intraoperative Pus Swabs in Perianal Abscess Management
Abigail Cheung, Nida Khan, Projit Kar, Lorcan Moore, Alfredo TonsiAbstract
Aims
Microbiology sampling is of limited value in the management of perianal abscesses and antibiotic use is not required in patients undergoing incision and drainage of uncomplicated anorectal abscesses, according to the Association of Coloproctology of Great Britain and Ireland (ACPGBI) consensus guidelines in emergency colorectal surgery; however, in clinical practice pus swabs are often taken and antibiotics are prescribed. This study looks to assess (1) the current practice in our hospital (2) whether culture results altered antibiotic choice.
Methods
Patients undergoing incision and drainage of perianal abscesses in emergency theatre within a 6-month period from January 2024 to June 2024 were retrospectively identified from our hospital’s electronic records. Patient demographics, operative notes, microbiology reports, patient notes, and clinic letters were analysed.
Results
A total of 30 patients were identified as being suitable for inclusion. Pus swab samples were sent in 24 (80%) cases. Microbiology results altered antibiotic choice in 1 (3%) case. In 23 (96%) cases, patients were discharged before receiving microbiology reports. No documentation at follow-up reviews mentioned microbiology reports or antibiotic changes. 24 (80%) patients received post-operative antibiotics, most commonly oral co-amoxiclav in 21 cases (88%).
Conclusion
The use of pus swabs during incision and drainage of uncomplicated perianal abscesses provides little clinical benefit and rarely affects antibiotic choice.