20.500.12556/RUL-184317 Open-label prospective randomized comparative study of the efficacy and safety of gentamicin in comparison to other antibiotics in the management of acute appendicitis in surgically treated patients Background: Antimicrobial resistance coupled with the lack of new antibiotics calls for the responsible use of antibiotics, including old antimicrobials. Aminoglycosides are effective against bacteria in acute appendicitis, a common intra-abdominal infection. Their use has been discouraged recently, but their place in therapy is based on studies performed in the era of lower resistance rates, and with multiple dosing regimens. Methods: In a prospective randomized open-label study, we compared the efficacy and safety of gentamicin in one daily dose and metronidazole (GTM+MZ) to ertapenem (ETP) and to cefuroxime with metronidazole (CXM+MZ) in adult patients surgically treated for acute appendicitis. Efficacy was assessed via the duration of antibiotic treatment and hospital stay, c-reactive protein (CRP) dynamics, and post-operative complications. Nephrotoxicity was assessed with urine biomarkers. Statistical analysis comprised mixed-model analysis of variance (ANOVA) with the missing-data-imputation method and linear mixed model (LMM). Results: One hundred-and-sixty-six patients were included in this study. There were no significant differences among the three groups in the durations of treatment and lengths of stay (p = 0.093, p = 0.222). CRP level was the lowest (p = 0.003) in the ETP group. There were five complications during hospitalization, with two of them classified as infectious. Both occurred in the GTM+MZ group; however, the difference was not statistically significant (p = 0.330). No difference was found in complications in the month following the operation (p = 0.763). Biomarkers indicating kidney injury showed the same trend in all three groups. Conclusions: Our results suggest the use of once-daily dose of gentamicin following an appendectomy for acute appendicitis. Gentamicin may be used to decrease selective pressure of other antimicrobials. appendicitis intra-abdominal infection antibiotics aminoglycosides nephrotoxicity slepič znotrajtrebušne okužbe antibiotiki aminoglikozidi nefrotoksičnos true false true Angleški jezik Slovenski jezik Članek v reviji 2026-07-03 16:43:51 2026-07-03 16:43:54 2026-07-15 14:39:19 0000-00-00 00:00:00 2026 0 0 21. str. iss. 4, art. 395 Vol. 15 2026 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 617 2079-6382 10.3390/antibiotics15040395 275160323 RAZ_Obolnar_Nika_2026.pdf RAZ_Obolnar_Nika_2026.pdf 1 8BF78A82E26B55C91109D4BEB49E2423 e376f861f9940600be7728655096add731c96df76af569dab86bf7959ac476d8 b27cb4cd-76ed-11f1-9b0d-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=236992 https://www.mdpi.com/2079-6382/15/4/395 1 81b58b85-76ed-11f1-9b0d-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=236991 Medicinska fakulteta 0 0 0