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Antibiotic therapy in pediatric acute appendicitis: Compliance with local protocol to reduce antibiotic overuse
J Surlemont1, D Lecuelle1, G Courbier1
1Department of Pediatric Surgery, CHU d'Amiens-Picardie, Site Sud, 80054 Amiens, France.
Insights
Pediatric appendicitis treatment compliance was poor, leading to antibiotic overuse without improving infection outcomes. Better medical team education and practice evaluation are needed for appropriate antibiotic use.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Pharmacology
Background:
- Acute appendicitis is a frequent pediatric surgical emergency.
- Standard treatment involves surgery and antibiotics.
- Local antibiotic protocols aim to standardize care.
Purpose of the Study:
- To evaluate adherence to local antibiotic guidelines for acute appendicitis.
- To analyze the impact of non-compliance on infectious complications.
Main Methods:
- Retrospective review of 142 children with appendicitis (2015-2017).
- Data collected on antibiotic therapy and infectious complications.
- Diagnosis confirmed surgically.
Main Results:
- Only 27.4% of patients received protocol-compliant antibiotic therapy.
- Excessive antibiotic duration (65%) and non-recommended combinations (32%) were common.
- Infectious complication rates were similar between compliant (12.8%) and non-compliant (11.6%) groups (P=0.85).
Conclusions:
- Poor compliance with appendicitis antibiotic guidelines leads to overuse without clinical benefit.
- Enhanced medical team education and regular practice audits are crucial.
- Optimizing antibiotic use in pediatric appendicitis requires improved adherence and oversight.
Purpose:
Acute appendicitis is one of the commonest surgical emergencies in pediatrics. Treatment usually consists of a combination of surgery and antibiotics. The present study was designed to assess compliance with our local antibiotic protocol and analyse the consequences of non-compliance.
Methods:
Children presenting with acute appendicitis between 2015 and 2017 were included in this study. The diagnosis of acute appendicitis was confirmed during surgery. Data concerning the antibiotic therapy received and infectious complications were reviewed.
Results:
A total of 142 children with acute appendicitis were included. Antibiotic therapy complied with the protocol in 27.4% of cases, while an excessive duration of antibiotic therapy was observed in 65% of cases. A total of 270 days of non-recommended antibiotic therapy was noted; 32% of patients received a non-recommended combination of antibiotics. The infectious complications rate was 12.8% in the group of patients receiving appropriate antibiotic therapy, and 11.6% in the group with non-compliance to the protocol. No statistically significant difference between the groups was found (P=0.85).
Conclusion:
Poor compliance with the antibiotic guidelines for appendicitis resulted in antibiotic overuse with no benefit in terms of anti-infective efficacy. Better information for the medical team and repeated evaluation of our practices are essential.
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