Perianal Abscess Recurrence and Fistula Formation: Antibiotics Following Incision and Drainage Trial (PARFAIT)
Perianal Abscess, Perianal Fistula
About this trial
This is an interventional prevention trial for Perianal Abscess focused on measuring Post-operative antibiotics
Eligibility Criteria
Inclusion Criteria:
- Patients aged ≥18 years
- Perianal abscess requiring incision and drainage
Exclusion Criteria:
- Allergies or contraindications to amoxicillin + clavulanic acid, penicillin, ciprofloxacin, or metronidazole
- Definite need to be on antibiotics at the treating clinicians' discretion
- Immunosuppression such as: human immunodeficiency virus (HIV), chronic steroids treatment, current chemotherapy
- Abscess associated with Inflammatory Bowel Disease (IBD)
- Supralevator perianal abscess
- Recurrent perianal abscesses within 5 years
- Known rectal cancer diagnosis within 5 years
- History of pelvic radiotherapy within 5 years
Sites / Locations
- North York General Hospital
- The Ottawa Hospital
- Sunnybrook Health Sciences Centre
Arms of the Study
Arm 1
Arm 2
Arm 3
Active Comparator
Active Comparator
No Intervention
Antibiotic 1 arm (amoxicillin + clavulanic acid)
Antibiotic 2 arm (ciprofloxacin + metronidazole)
No antibiotics
Patients will undergo I&D of PA by the clinician as per standard of care. This may occur in the emergency department or operating room. Patients may or may not receive packing based on the clinician's standard practice and institutional routines. Patients randomized to the antibiotic 1 arm will receive a prescription for amoxicillin + clavulanic acid (875 mg amoxicillin and 125 mg clavulanic acid BID) PO for 7 days. Otherwise, all participants will be treated identically according to the institution's standard practices.
Patients will undergo I&D of PA by the clinician as per standard of care. This may occur in the emergency department or operating room. Patients may or may not receive packing based on the clinician's standard practice and institutional routines. Patients randomized to the antibiotic 2 arm will receive a prescription for ciprofloxacin + metronidazole (ciprofloxacin 500 mg and metronidazole 500 mg BID) PO for 7 days. Otherwise, all participants will be treated identically according to the institution's standard practices.
Patients will undergo I&D of PA by the clinician as per standard of care. This may occur in the emergency department or operating room. Patients may or may not receive packing based on the clinician's standard practice and institutional routines. In the comparator arm, patients will not receive any antibiotics. Otherwise, all participants will be treated identically according to the institution's standard practices.