Postoperative organ space infection (OSI) following appendectomy: early term evaluation for pediatric population

Area of Science:

• Pediatric Surgery
• Infectious Diseases
• Clinical Outcomes

Background:

• Postoperative organ space infection (OSI) is a concern after appendectomy.
• Optimal antibiotic prophylaxis duration for pediatric complex appendicitis remains unclear.
• Current practices vary, lacking consensus on extended antibiotic use.

Purpose of the Study:

• To evaluate the impact of antibiotic administration duration on postoperative OSI in children with complex appendicitis.
• To compare outcomes between short-duration and long-duration antibiotic groups.
• To determine if prolonged antibiotic prophylaxis offers benefits for OSI resolution or recurrence.

Main Methods:

• Multicenter retrospective study of pediatric patients with OSI post-complicated appendicitis (2017-2019).
• Patients divided into short (<5.5 days) and long (>5.5 days) antibiotic groups based on median duration.
• Propensity score matching used to control for baseline characteristic biases.

Main Results:

• No significant difference in time to OSI resolution or recurrence between short and long-duration groups.
• Short-duration group showed a trend towards lower complication rates, including abdominal distention (p=0.093).
• Significantly lower incidence of antibiotic-associated diarrhea in the short-duration group (p=0.024).
• No significant differences in readmission rates or hospitalization duration.

Conclusions:

• Long-term antibiotic administration did not provide significant benefit for OSI following complicated appendicitis in children.
• Shorter antibiotic durations appear safe and may reduce associated complications like diarrhea.
• Findings suggest a potential for de-escalation of antibiotic therapy duration in this patient population.