Shannon N Acker1, Amanda L Hurst2, Denis D Bensard3, Anna Schubert4, Lindel Dewberry5, Danielle Gonzales6, Sarah K Parker7, Suhong Tong8, David A Partrick9. 1. Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA. Electronic address: Shannon.acker@ucdenver.edu. 2. Department of Pharmacy, Children's Hospital Colorado, Aurora, CO, USA. Electronic address: Amanda.hurst@childrenscolorado.org. 3. Department of Surgery, Denver Health Medical Center, Denver, CO, USA. Electronic address: denis.bensard@dhha.org. 4. Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA. Electronic address: anna.schubert@ucdenver.edu. 5. Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA. Electronic address: lindel.dewberry@ucdenver.edu. 6. Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA. Electronic address: Danielle.gonzales@ucdenver.edu. 7. Division of Pediatric Infectious Disease, Department of Pediatrics, Children's Hospital Colorado, Aurora, CO, USA. Electronic address: sarah.parker@childrenscolorado.org. 8. Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA. Electronic address: suhong.tong@childrenscolorado.org. 9. Department of Pediatric Surgery, Children's Hospital Colorado, Aurora, CO, USA. Electronic address: david.partrick@childrenscolorado.org.
Abstract
INTRODUCTION: Following complicated appendicitis, there are limited data available to guide the surgeon regarding antibiotic selection, specifically in regards to route of administration. We hypothesized that among children with appendicitis who are discharged home with antibiotic therapy, the post-discharge readmission and complication rates do not differ between those children who receive IV antibiotics and those who receive PO antibiotics. METHODS: We performed a retrospective review of all children discharged home on antibiotics following appendectomy at a single institution between 11/10-10/14. We compared outcomes including ED and hospital readmission rates, and development of postoperative complications, between those children who were discharged on IV antibiotics and those discharged on PO antibiotics. RESULTS: 325 children were discharged with antibiotics following appendectomy (n=291 PO antibiotics group; n=34 IV group). On both univariate and multivariate analysis, rate of each complication did not differ between the two groups including inpatient readmission (5% PO vs. 6% IV; p=0.8), ED readmission (10% vs. 11%; p=0.8), postdischarge complications related to the operation (10% vs. 15%; p=0.4), or abscess development post-discharge (4% vs. 3%; p=1). CONCLUSIONS: Among children with complicated appendicitis who are discharged home with ongoing antibiotic therapy, our data demonstrate no differences in outcomes between those children who receive IV and PO antibiotics. Further data, collected in a prospective fashion, are needed to clarify the role of IV and PO antibiotics among children with perforated appendicitis.
INTRODUCTION: Following complicated appendicitis, there are limited data available to guide the surgeon regarding antibiotic selection, specifically in regards to route of administration. We hypothesized that among children with appendicitis who are discharged home with antibiotic therapy, the post-discharge readmission and complication rates do not differ between those children who receive IV antibiotics and those who receive PO antibiotics. METHODS: We performed a retrospective review of all children discharged home on antibiotics following appendectomy at a single institution between 11/10-10/14. We compared outcomes including ED and hospital readmission rates, and development of postoperative complications, between those children who were discharged on IV antibiotics and those discharged on PO antibiotics. RESULTS: 325 children were discharged with antibiotics following appendectomy (n=291 PO antibiotics group; n=34 IV group). On both univariate and multivariate analysis, rate of each complication did not differ between the two groups including inpatient readmission (5% PO vs. 6% IV; p=0.8), ED readmission (10% vs. 11%; p=0.8), postdischarge complications related to the operation (10% vs. 15%; p=0.4), or abscess development post-discharge (4% vs. 3%; p=1). CONCLUSIONS: Among children with complicated appendicitis who are discharged home with ongoing antibiotic therapy, our data demonstrate no differences in outcomes between those children who receive IV and PO antibiotics. Further data, collected in a prospective fashion, are needed to clarify the role of IV and PO antibiotics among children with perforated appendicitis.
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