INTRODUCTION: In a previous prospective randomized trial, we found a once-a-day regimen of ceftriaxone and metronidazole to be an efficient, cost-effective treatment for children with perforated appendicitis. In this study, we evaluated the safety of discharging patients to complete an oral course of antibiotics. METHODS:Children found to have perforated appendicitis at the time of laparoscopic appendectomy were enrolled in the study. Perforation was defined as a hole in the appendix or fecalith in the abdomen. Patients were randomized to antibiotic treatment with either once daily dosing of ceftriaxone and metronidazole for a minimum of 5 days (intravenous [IV] arm) or discharge to home on oral amoxicillin/clavulanate when tolerating a regular diet (IV/PO arm) to complete 7 days. RESULTS:One hundred two patients underwentlaparoscopic appendectomy for perforated appendicitis. On presentation, there were no differences in age, weight, sex distribution, days of symptoms, maximum temperature, or leukocyte count between the 2 groups. There was no difference in the postoperative abscess rate between the two treatment groups. Discharge was possible before day 5 in 42% of the patients in the IV/PO arm. CONCLUSIONS: 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. Copyright 2010 Elsevier Inc. All rights reserved.
RCT Entities:
INTRODUCTION: In a previous prospective randomized trial, we found a once-a-day regimen of ceftriaxone and metronidazole to be an efficient, cost-effective treatment for children with perforated appendicitis. In this study, we evaluated the safety of discharging patients to complete an oral course of antibiotics. METHODS:Children found to have perforated appendicitis at the time of laparoscopic appendectomy were enrolled in the study. Perforation was defined as a hole in the appendix or fecalith in the abdomen. Patients were randomized to antibiotic treatment with either once daily dosing of ceftriaxone and metronidazole for a minimum of 5 days (intravenous [IV] arm) or discharge to home on oral amoxicillin/clavulanate when tolerating a regular diet (IV/PO arm) to complete 7 days. RESULTS: One hundred two patients underwent laparoscopic appendectomy for perforated appendicitis. On presentation, there were no differences in age, weight, sex distribution, days of symptoms, maximum temperature, or leukocyte count between the 2 groups. There was no difference in the postoperative abscess rate between the two treatment groups. Discharge was possible before day 5 in 42% of the patients in the IV/PO arm. CONCLUSIONS: 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. Copyright 2010 Elsevier Inc. All rights reserved.
Authors: Michael R Arnold; Blair A Wormer; Angela M Kao; David A Klima; Paul D Colavita; Graham H Cosper; Brant Todd Heniford; Andrew M Schulman Journal: Pediatr Surg Int Date: 2018-09-14 Impact factor: 1.827
Authors: Joseph A Sujka; Katrina L Weaver; Justin A Sobrino; Ashwini Poola; Katherine W Gonzalez; Shawn D St Peter Journal: Pediatr Surg Int Date: 2018-12-03 Impact factor: 1.827
Authors: Nathan M Krah; Tyler Bardsley; Richard Nelson; Lawanda Esquibel; Mark Crosby; Carrie L Byington; Andrew T Pavia; Adam L Hersh Journal: Hosp Pediatr Date: 2019-04
Authors: Peter C Minneci; Jason P Sulkowski; Kristine M Nacion; Justin B Mahida; Jennifer N Cooper; R Lawrence Moss; Katherine J Deans Journal: J Am Coll Surg Date: 2014-04-13 Impact factor: 6.113
Authors: Andrew P Rogers; Tiffany J Zens; Charles M Leys; Peter F Nichol; Daniel J Ostlie Journal: J Pediatr Surg Date: 2016-10-27 Impact factor: 2.545
Authors: Hanna Alemayehu; Amita A Desai; Priscilla Thomas; Susan W Sharp; Shawn D St Peter Journal: Pediatr Surg Int Date: 2014-01-28 Impact factor: 1.827