Antibiotic Treatment in Complicated Appendicitis: Can It Be Optimized?
Isr Med Assoc J
; 26(1): 30-33, 2024 Jan.
Article
en En
| MEDLINE
| ID: mdl-38420639
ABSTRACT
BACKGROUND:
The management of complicated appendicitis is inconclusive. Guidelines have not been established for the use of personalized antibiotic treatment.OBJECTIVES:
To investigate specific risk factors to consider during the initial first-choice antibiotic therapy in children with complicated appendicitis.METHODS:
This study included all pediatric patients younger than 18 years of age who underwent a laparoscopic appendectomy during 2012-2022 at a single tertiary medical center.RESULTS:
In total, 300 pediatric patients underwent laparoscopic appendectomy due to complicated appendicitis. The patients were treated with ceftriaxone + metronidazole (CM). For 57 (19%) patients, the empirical treatment was changed to tazobactam/piperacillin (TP) due to resistant bacteria or clinical deterioration. The presence of generalized peritonitis during surgery and C-reactive protein (CRP) levels above 20 mg/L at admission were identified as risk factors for changing the antibiotic regimen from CM to TP.CONCLUSIONS:
Generalized peritonitis and CRP > 20 gr/L were highly correlated with changing the antibiotic regimen to TP. For such patients, initial treatment with TP may result in clinical improvement and shorter hospitalization.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Apendicitis
/
Peritonitis
Límite:
Child
/
Humans
Idioma:
En
Revista:
Isr Med Assoc J
Asunto de la revista:
MEDICINA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Israel