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[Sequential antibiotic therapy in complicated acute appendicitis]
José Carlos Bueno-Rodríguez1, Elizabeth Hernández-Moore, Dayamnelis Aguilar-Atanay
1Hospital Pediátrico Provincial Docente Dr. Eduardo Agramonte Piña, Camagüey, Cuba. jcbueno2010@yahoo.es
Insights
Sequential postoperative antibiotics in children with complicated appendicitis significantly reduce hospital stays and costs. This approach offers a more efficient and economical treatment strategy for pediatric patients.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Pharmacology
Context:
- Complicated appendicitis in children often requires appendectomy followed by intravenous antibiotics.
- Current treatment protocols involve prolonged parenteral antibiotic use.
- There is a need for more efficient and cost-effective postoperative antibiotic strategies.
Purpose:
- To evaluate the feasibility and outcomes of using sequential intravenous (IV) and oral antibiotics post-appendectomy in pediatric complicated appendicitis.
- To compare the length of hospital stay and treatment costs between sequential and conventional antibiotic regimens.
Summary:
- A controlled clinical trial involved 27 children with complicated appendicitis. Twelve received sequential IV-then-oral antibiotics, while 15 had conventional treatment.
- The sequential group experienced a shorter hospital stay (3.61 days) compared to the conventional group (6.86 days).
- Treatment costs were substantially lower in the sequential antibiotic group ($256.56 USD) versus the conventional group ($581.99 USD increase).
Impact:
- Sequential postoperative antibiotic therapy can reduce hospital length of stay in pediatric appendicitis.
- This approach offers significant cost savings in the management of complicated appendicitis.
- Findings support the potential for optimizing antibiotic use in pediatric surgical infections.
Background:
In many centers of pediatric care, treatment for complicated appendicitis includes appendectomy followed by the use of parenteral broad spectrum antibiotics by. The aim of the study is to demonstrate the possibility of use of oral antibiotics during the postoperative period in children with complicated acute appendicitis, after a short administration of intravenous antibiotics.
Methods:
This study shows the initial results of a controlled clinical trial on the use of postoperative sequential antibiotics (i.v. and oral) in children treated for complicated acute appendicitis.
Results:
Between August and November 2009, 29 children were diagnosed and treated for complicated acute appendicitis in the Department of Pediatric Surgery. Of these children, 27 were included in the study. Twelve children received sequential postoperative antibiotic therapy (i.v. and oral) and 15 were treated according to the conventional scheme. The length of hospital stay was 3.61 days in the group children with sequential treatment, whereas in the group treated conventionally the hospital stay was 6.86 days. Costs were $256.56 USD in the group with sequential treatment with an increase of $581.99 USD for the group treated conventionally.
Conclusions:
Initial results show a shorter hospital stay and lower costs for the group of children with sequential postoperative antimicrobial therapy.
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