The predictive value of the third day temperature in the decision whether to continue or terminate antibiotic treatment in perforated appendicitis.

The third day temperature is frequently used in the decision whether to continue or terminate antibiotic treatment following appendicectomy in perforated appendicitis. To assess the value of the third day temperature in predicting intraperitoneal infectious complications we studied 235 consecutive patients treated with a 3-day course of cefoxitin after surgery for perforated appendicitis. The results demonstrated that regardless of the level of elevated temperature chosen, the predictive value ranged between 16 and 33%. In consequence, elevated third day temperature per se does not provide any rational basis for continuing antibiotic treatment in order to prevent intraperitoneal infectious complications following appendectomy in perforated appendicitis.