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[Fast track antibiotic protocol in acute appendicitis]

I Tuduri Limousin1, J Morcillo Azcárate, R Granero Cendón

  • 1Servicio de Cirugía Pediátrica, Hospital Infantil Virgen del Rocío, Sevilla. tuduri@yahoo.com

Cirugia Pediatrica : Organo Oficial De La Sociedad Espanola De Cirugia Pediatrica
|December 5, 2009
PubMed
Abstract

Insights

A new 72-hour antibiotic protocol for appendicitis significantly reduced infectious morbidity and intra-abdominal abscesses. This fast-track approach allows for early patient discharge without increasing readmission rates, addressing rising antimicrobial resistance.

Area of Science:

  • Infectious Diseases
  • Surgical Infections
  • Antimicrobial Stewardship

Context:

  • Rising antimicrobial resistance challenges traditional appendicitis treatment.
  • Triple antimicrobial therapy efficacy is declining, increasing patient morbidity.
  • A fast-track protocol using Cefuroxime-Metronidazole or Ertapenem was implemented.

Purpose:

  • To evaluate the impact of a new fast-track antibiotic protocol on infectious morbidity rates.
  • To determine the feasibility of early patient discharge in appendicitis cases.
  • To assess changes in infectious complications and readmission rates.

Summary:

  • An analytic historic cohort study compared patients before and after protocol implementation.
  • The new protocol reduced hospital stay by 2.82 days and intra-abdominal abscess risk (RR 0.366).
  • Readmission rates decreased significantly from 9.8% to 0%, with no increase in complications.

Impact:

  • The new protocol effectively decreased infectious morbidity in appendicitis patients.
  • Early discharge is feasible for perforated appendicitis without compromising patient safety.
  • Understanding local bacterial flora is crucial for optimizing antibiotic therapy in appendicitis.

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