Related Experiment Video

Updated: May 19, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Antibiotic administration can be an independent risk factor for therapeutic delay of pediatric acute appendicitis

Osamu Nomura1, Akira Ishiguro, Takanobu Maekawa

  • 1Department of General Pediatrics and Interdisciplinary Medicine, National Center for Child Health and Development, Tokyo, Japan. nomura-o@ncchd.go.jp

Pediatric Emergency Care
|August 4, 2012
PubMed

Insights

Prior antibiotic use in children with acute appendicitis (AA) significantly increases the risk of delayed diagnosis and treatment. This delay is associated with more severe outcomes, including perforation.

Area of Science:

  • Pediatric Surgery
  • Infectious Diseases
  • Clinical Research

Background:

  • Acute appendicitis (AA) diagnosis and treatment delays in children are poorly understood.
  • Prior antibiotic exposure is a potential, yet understudied, factor influencing these delays.

Purpose of the Study:

  • To investigate the relationship between previous antibiotic treatment and delayed diagnosis/treatment in pediatric acute appendicitis.
  • To identify independent risk factors for therapeutic delay in pediatric AA.

Main Methods:

  • Retrospective chart review of pediatric patients with AA operated on between 2003 and 2008.
  • Univariate and multivariate logistic regression analyses to identify risk factors for therapeutic delay (defined as >48 hours from symptom onset to surgery).

Main Results:

  • Therapeutic delay occurred in 25% of pediatric AA cases.
  • Prior antibiotic use (46% vs 8%), diarrhea (48% vs 12%), and elevated C-reactive protein levels were significantly more frequent in delayed cases.
  • Multivariate analysis confirmed prior antibiotics (OR 5.8), diarrhea (OR 5.2), and high C-reactive protein (OR 4.5) as independent risk factors for delay.

Conclusions:

  • Previous antibiotic treatment is an independent risk factor for therapeutic delay in pediatric acute appendicitis.
  • Diarrhea and elevated C-reactive protein levels also contribute to delayed diagnosis and treatment in pediatric AA.
Abstract

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