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Introduction: Acute appendicitis is a frequent cause of abdominal pain and its most frequent complication is surgical site infection, with pelvic involvement being very rare. The following is a case of a patient with pelvic inflammatory disease as postoperative complication after appendectomy. The patient was admitted for abdominal pain several weeks after an appendectomy, without signs of incisional surgical site infection but with a CT scan that reported a left hydrosalpinx. The patient progresses with clinical deterioration despite resuscitation with crystalloids and broadspectrum antibiotics. A laparotomy was performed for infection control. A left hydrosalpinx was found and needed a second surgery due to right adnexal involvement. After this she recovered. Conclusion: Pelvic inflammatory disease is a rare but possible etiology of the acute abdomen in patients who’s never had sexual intercourse.

Objective: To measure the impact on the quality of the empirical antibiotic prescription in general practitioners, after the implementation of an evaluation and feedback system. Methods: Quasi-experimental study with pre and post intervention in a tertiary care center in Medellín. The prescriptions of a group of antibiotics were reviewed by an internist, an epidemiologist and an infectologist. When failures were found, prescribing doctors were informed. Subsequently, antibiotic consumption, feedbacks, sepsis diagnosis, start time of antibiotics in the emergency department and monthly incidence of Escherichia coli producing extended spectrum betalactamase were measured. Results: The numbers of feedbacks decreased from 10.9% to 2%. Consumption of ceftriaxone (p = 0.04), piperacillin tazobactam (p = 0.01), cefepime (p = 0.04) and ciprofloxacin (p = 0.01) was reduced. There was a tendency to reduce the prevalence of E. coli ESBL. The intervention did not cause a delay in the start of antibiotics in the emergency department. Conclusions: A strategy of continuous feedback to ge-neral practitioners regarding the quality of antibiotic prescription reduces consumption of antibiotics without causing changes in diagnosis opportunity or the beginning of antibiotics in sepsis and can impact favorably the resistance profile of the institutional microbial flora.