Early transition to oral antibiotics for treatment of perforated appendicitis in pediatric patients: Confirmation of the safety and efficacy of a growing national trend

Fast‐track surgery for acute appendicitis in children: a systematic review of protocol‐based care

“…All studies that investigated cost reported cost benefit with protocol or pathway implementation. The greatest financial saving reported was a 52% reduction in hospital cost; however, the same study also cited a modest increase in readmission rates from 13% to 18% ( P = 0.05) …”

“…A significant reduction in LOS was achieved in eight studies (Table S4). Importantly, in all but one study these outcomes occurred with either comparable or improved rates of complication or readmission .…”

“…35 The importance of tolerating oral intake of fluid or solid diet, and adequate oral analgesia was heavily emphasized in many studies. [24][25][26][27][28][29][30][31][32][33][34] A significant reduction in LOS was achieved in eight studies 25,27,29,[33][34][35][36][37] (Table S4). Importantly, in all but one study these outcomes occurred with either comparable or improved rates of complication or readmission.…”

“…The greatest financial saving reported was a 52% reduction in hospital cost; however, the same study also cited a modest increase in readmission rates from 13% to 18% (P = 0.05). 37 Antibiotic-related variables were the dominant protocol elements. These included antibiotic selection, duration and timing for transition to oral agents.…”

“…ampicillin, gentamicin and clindamycin or metronidazole) to monotherapy (e.g. piperacillin/tazobactam) 27,32,33,37,38 (Table S1). The trend towards monotherapy in more recent studies is supported by favourable results for this strategy, although an intravenous broad-spectrum cephalosporin (e.g.…”