Efficacy of oral antibiotics in children with post-operative abscess from perforated appendicitis.
BACKGROUND: Post-operative intra-abdominal abscess (PIAA) is the most common complication after appendectomy for perforated appendicitis (PA). Typically, intravenous antibiotics by a peripherally inserted venous catheter are utilized to treat the abscess. We sought to evaluate the role of oral antibiotics in this population.
METHODS: This is a retrospective review conducted of children between January 2005 and September 2015 with a PIAA. Demographics, clinical course, complications, and follow-up were analyzed using descriptive statistics. Comparative analysis was performed on those who were treated with oral vs IV antibiotics after diagnosis of PIAA.
RESULTS: 103 children were included. Days of symptoms prior to admission were 3.2 ± 2.3 days with a WBC of 17.9 ± 6.4. Median time to diagnosis of PIAA from appendectomy was 7 days (7, 10). Mean total length of stay was 10 ± 3.4 days. 42% were treated with oral antibiotics (n = 43) versus 58% IV antibiotics (n = 60) at the time of discharge. We found a significant increase in total length of hospital stay (9.1 vs 10.7, p = 0.02) and number of medical encounters required for treatment (3.4 vs 4.4, p ≤ 0.01) in the IV group.
CONCLUSIONS: PIAA treatment after appendectomy for PA can be treated with oral antibiotics with equivalent outcomes as IV antibiotic treatment, but with shorter length of hospitalizations and less medical encounters required.
Pediatric surgery international
Abdominal Abscess; Anti-Bacterial Agents; Appendectomy; Appendicitis; Child; Female; Humans; Length of Stay; Male; Postoperative Care; Retrospective Studies; Surgical Wound Infection; Treatment Outcome
Antibiotics; Appendicitis; Intravenous; Oral; Pediatric; Perforated
Sujka JA, Weaver KL, Sobrino JA, Poola A, Gonzalez KW, St Peter SD. Efficacy of oral antibiotics in children with post-operative abscess from perforated appendicitis. Pediatr Surg Int. 2019;35(3):329-333. doi:10.1007/s00383-018-4424-0