Improvements in Antimicrobial Prescribing and Outcomes in Pediatric Complicated Appendicitis

Abstract

Complicated appendicitis is an important target for antimicrobial stewardship and quality improvement efforts. A condition-specific CPG can improve both antimicrobial utilization and clinical outcomes.

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

“…Time without fever was one of the most common discharge criteria. The required period without fever ranged between 12 and 72 hours . Only one small underpowered study explicitly excluded a body temperature value from their discharge criteria, with comparable complication rates and LOS reported .…”

“…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 . Yousef et al and Willis et al notably reported reductions in intra‐abdominal abscess rate by approximately half.…”

“…The required period without fever ranged between 12 and 72 hours. [24][25][26][27][28][29][30][31][32][33][34] Only one small underpowered study explicitly excluded a body temperature value from their discharge criteria, with comparable complication rates and LOS reported. 35 The importance of tolerating oral intake of fluid or solid diet, and adequate oral analgesia was heavily emphasized in many studies.…”

“…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.…”

“…Importantly, in all but one study these outcomes occurred with either comparable or improved rates of complication or readmission. 25,26,[33][34][35][36] Yousef et al 26 and Willis et al 27 notably reported reductions in intra-abdominal abscess rate by approximately half. All studies that investigated cost reported cost benefit with protocol or pathway implementation.…”