Metronidazole plus cefazolin versus cefazolin in gangrenous and perforated appendicitis in childhood--a prospective randomised trial.

59 children with gangrenous (n = 11) or perforated (n = 48) appendicitis underwent a prospective, randomized trial and received cefazolin or cefazolin plus metronidazole. Whereas postoperative abscesses developed in 44% of the controls, they were seen in 7% of the children who had received metronidazole (p less than 0.001). Relaparotomy for intestinal obstruction had to be performed in 11% and 13% of the cases respectively. The germ most frequently isolated from the abscesses was Bacteroides fragilis.