A complete course of intravenous antibiotics vs a combination of intravenous and oral antibiotics for perforated appendicitis in children: a prospective, randomized trial

Fraser, Jason D.; Aguayo, Pablo; Leys, Charles M.; Keckler, Scott J.; Newland, Jason G.; Sharp, Susan W.; Murphy, John P.; Snyder, Charles L.; Sharp, Ronald J.; Andrews, Walter S.; Holcomb, George; Ostlie, Daniel J.; Peter, Shawn D. St.

doi:10.1016/j.jpedsurg.2010.02.090

Cited by 135 publications

(101 citation statements)

References 11 publications

(16 reference statements)

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“…Discharge was possible before day5 in 42% of the patients in the IV/PO arm. The authors concluded that when patients are able to tolerate a regular diet, completing the course of antibiotics orally decreases hospitalization with no effect on the risk of postoperative abscess formation [12]. The effectiveness and safety of single daily dosing CM for conservative therapy of complicated appendicitis in children has been shown in a prospective, randomized trial in children who presented with a well defined abdominal abscess by abdominal CT.…”

Section: Discussionmentioning

confidence: 99%

Single Daily Dosing of Ceftriaxone and Metronidazole is as Safe and Effective as Ampicillin, Gentamicin and Metronidazole for Non-operative Management of Complicated Appendicitis in Children

L¹

2013

Pediat Therapeut

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Introduction: Perforated appendicitis very common abdominal emergency in children and nonoperative management with Ampicillin Gentamicin and Metronidazole (AGM) has shown good results. Recent data show that single daily dosing of Ceftriaxone and Metronidazole (CM) is as safe and effective as ampicillin gentamicin and clindamycin for treatment of perforated appendicitis after surgery in children. Treatment of complicated appendicitis in children with once daily CM can decrease the risk of in drug administration's mistake, require the patient to be connected to the IV line for short time only once a day, may cause less IV line infection and may cost less. The aim of this study was to compare the effectiveness, and safety of CM with the traditional triple antibiotic for conservative treatment of complicated appendicitis children.

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Section: Discussionmentioning

confidence: 99%

Single Daily Dosing of Ceftriaxone and Metronidazole is as Safe and Effective as Ampicillin, Gentamicin and Metronidazole for Non-operative Management of Complicated Appendicitis in Children

L¹

2013

Pediat Therapeut

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“…Therefore, an empiric length of time for antibiotics may result in many patients receiving IV antibiotics for a longer time than necessary. There is Grade B evidence that the length of administration of IV antibiotics should be based on clinical criteria, such as fever, pain, return of bowel function, and white blood cell (WBC) count [10,11].…”

Section: 22mentioning

confidence: 99%

Antibiotics and appendicitis in the pediatric population: an American Pediatric Surgical Association Outcomes and Clinical Trials Committee Systematic Review

Lee¹,

Islam²,

Cassidy³

et al. 2010

Journal of Pediatric Surgery

124

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“…Patients with perforated appendicitis are universally given postoperative antibiotics, which is necessary to reduce the complications of wound infection and pelvic abscess, however the use of postoperative antibiotics for preventing infective complications in nonperforated cases is still controversial [6,7]. Subjected to Open Appendectomy Some adverse events are also associated with postoperative antibiotic use like clostridium difficile infection, bacterial resistance and postoperative diarrhea, prolonged hospital stay, increase in financial burden.…”

Section: Introductionmentioning

confidence: 99%

Postoperative Use of Antibiotics in Adults with Non-perforated Appendicitis Subjected to Open Appendectomy

Mlees¹

2017

ASS

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Acute appendicitis is the most common cause of acute abdominal pain necessitating appendicectomy. The aim of this study was to determine the role of postoperative antibiotics in non-perforated appendicitis regarding; superficial site infections (SSIs), deep site infections (DSIs), complications and the length of hospital stay. This prospective study was carried out on 112 patients diagnosed as acute appendicitis at the Emergency Hospital, General Surgery Department, Tanta University Hospital from March 2014 to April 2016. The patients classified into two groups: Group 1: patients who received postoperative antibiotics, these included 55 patients and Group 2: patients who did not receive postoperative antibiotics and these included 57 patients. The patients subjected to open appendectomy through a standard Grid-Iron incision. The patients' characteristics, ultrasound findings, antibiotics regimen, operative diagnosis, length of hospital stay, wound infection, complications and histopathological findings were analysed using SPSS V 20. Out of 112 patients, 72 patients were male and 40 patients were female. The patients' age ranged from 18 to 55 years with a mean age of 26 years. There is no significant difference regarding patient's age, sex, medical comorbidities, fever, radiologic findings or operative time between the two groups. Treatment with postoperative antibiotics did not significantly reduce the risk of developing superficial SSIs, DSIs. The patients received postoperative antibiotics were significantly more likely to sustain urinary tract infection (P=0.03) a postoperative diarrhea (P = 0.02), increased risk of Clostridium difficile infection (P =0.01) with higher rates of both readmission (P= 0.08) and reoperation (P = 0.07) with a significantly longer hospital stay (2.6 vs 1.4 days, P = 0.001). The use of postoperative antibiotic treatment for nonperforated appendicitis did not reduce the infectious complications while increasing postoperative morbidity and increase the length of hospital stay.

show abstract

A complete course of intravenous antibiotics vs a combination of intravenous and oral antibiotics for perforated appendicitis in children: a prospective, randomized trial

Cited by 135 publications

References 11 publications

Single Daily Dosing of Ceftriaxone and Metronidazole is as Safe and Effective as Ampicillin, Gentamicin and Metronidazole for Non-operative Management of Complicated Appendicitis in Children

Single Daily Dosing of Ceftriaxone and Metronidazole is as Safe and Effective as Ampicillin, Gentamicin and Metronidazole for Non-operative Management of Complicated Appendicitis in Children

Antibiotics and appendicitis in the pediatric population: an American Pediatric Surgical Association Outcomes and Clinical Trials Committee Systematic Review

Postoperative Use of Antibiotics in Adults with Non-perforated Appendicitis Subjected to Open Appendectomy

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