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Latar belakang : Pemberian cefotaxim ada yang menganjurkan 3 kali per han ada pula yang menganjurkan 2 kali per hari. Yang menganjurkan 2 kali per hari mendasarkan pada adanya efek bakterisidal dan metabolit desacethyl cefotaxime yang bersama-sama dengan sisa cefotaxime yang ada setelah 12 jam pemberian . kadarnya masih di atas MIC kebanyakan patogen. Kebanyakan kepustakaan barat menganjurkan dosis 2×2 gram untuk pengobatan peritonitis bakierial sekunder. Rata-rata berat badan orang barat secara nyata lebih tinggi dibanding orang Indonesia.
Tujuan penelitian. Untuk menilai manfaat klinik pemberian cefotaxime dosis rendah (2x gram) dikombinasi dengan metronidazole 3×500 mg pada penderita peritonitis bakterialis karena apendisitis perforata yang menjalani laparatomi.

Pasien dan metoda : Pasien umur di atas 14 tahun yang dirawat di RS St. Elizabeth Semarang periode Mei 1999-Mei 2000, dengan diagnosa peritonitis generalisata karena apendisitis perforata dimasukkan dalam trial terbuka pemberian cefotaxime 2×1 gram dan metronidazole 3×500 mgr. Dinilai co-morbid, lama panas setelah pembedahan, komplikasi infeksi nosokomial, lama pemberian antibiotika dan efek samping obat.

HasiL: Didapatkan 19 kasus dengan umur rata-rata 29,8 (15-52 tahun), 14 laki-laki dan 5 wanita, co-morbid didapatkan obesitas pada 1 kasus dan DM 1 kasus, rata-rata lama panas setelah pembedahan 1,8 (0-4 han) dengan moda 2 han, nosolcomial infeksi didapat 1(5,23%) berupa infeksi luka operasi ringan pada pasien obesitas dan rata-rata antibiotika dihentikan pada hari ke-4 (3-5 han). Tidak ditemukan efek samping obat pada sen mi.

Kesimpulan. Pemberian cefotaxim 2×1 gram dan metronidazole 3×500 mg pada peritonitis bakterialis sekunder akibat apendisitis perforata yang menjalani laparatomi, memberikan manfaat yang baik dan tidak memberikan efek samping.

Background: Interval of administering cefotaxime is still controversy. One group advices 3 times per day, the other ‘s give 2 times per day. Authors who advice 2 times per day were based on the fact that the metabolite of cefotaxime, desacethyl cefotaxime, has bactericidal effect and its concentration together with the rest of cefotaxime after 12 hours administration are still above the MIC of many pathogens. Most of the western authors advice 2×2 gram of cefotaxime with 3×500 mg metronidazole for secondary bacterial peritonitis with good result. The mean of body weight of western country is higher compared to the Indonesian people. Objective of study. To evaluate clinical efficacy of low dose cefota.xime (2×1 gram) in combination with 3×500 mg metronidazole for bacterial peritonitis secondary to perforated appendicitis who underwent surgery.
 
Patient & method. Patient admitted on St. Elizabeth hospital, period May 1999-May 2000, age above 14 years old, diagnose as bacterial peritonitis caused by perforated appendicitis who underwent surgery, were allocated to open clinical trial. All of the patients were gave cefotaxime 2×1 gram and metronidazole 3×500 mg one hour before and after surgery. Co-morbid, the duration of fever after surgery, nosocomial infection, duration of giving antibiotic and side effect were evaluated.
 
Result. Total number of study cases were 19, mean of age was 29,8 (/5-52 years), 14 were men and 5 were women. co-morbids were obesity in I case and Diabetes Mellitus in I case. The mean duration offever after surgery was 1,8 (0-4 days). Nosocomial infection was on 1(5,23%) patients, it was light wound infection in the obesity patients. The mean duration of antibiotic was 4 (3-5 days). No side effects were noted in this series.
 
Conclusion. Low dose Cofotaxime (2×1 gram) in combination with 3×500 mg metronidazole given to the bacterial peritonitis caused by perforated appendicitis who underwent surgery, gives good clinical result without side effect.