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Comparative Approaches of Antibiotic Therapy and Surgical Intervention in Managing Recurrent Perirectal Abscess in
Amrollah Salimi1, Mohadeseh Najafi1, Ahmad Kachoie1
1Department of Surgery, School of Medicine, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran.
Insights
Antibiotic therapy is the preferred treatment for perianal abscesses in young children, showing the lowest recurrence rates and quick symptom resolution. This approach is recommended for managing and preventing abscess relapses in infants.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Clinical Pediatrics
Background:
- Recurrent perianal abscesses in infants under two years present significant management challenges.
- High relapse rates necessitate effective treatment strategies, with limited comparative data on antibiotic therapy versus surgical drainage.
- Understanding long-term outcomes is crucial for optimizing pediatric perianal abscess management.
Purpose of the Study:
- To compare the efficacy of different antibiotic treatment approaches and surgical interventions for perianal abscesses in children under two years old.
- To evaluate recurrence rates and fistula formation associated with various treatment modalities.
- To identify the optimal primary treatment strategy for pediatric perianal abscesses.
Main Methods:
- A retrospective cohort study involving 336 children under two years with perianal abscesses treated between 2012-2019.
- Patients were categorized into three groups: antibiotic treatment only, spontaneous drainage, and incision and drainage (I&D).
- Analysis included demographics, abscess characteristics, and outcomes (recurrence, fistula), utilizing SPSS version 26.
Main Results:
- No significant demographic differences (age, weight, sex, nutrition) were found across the three treatment groups.
- The incision and drainage group presented with larger and more distally located abscesses (P<0.05).
- The spontaneous drainage group exhibited a significantly higher recurrence rate (37%), while the antibiotic-only group showed faster symptom resolution (average 6 days) and lower colic prevalence.
Conclusions:
- Antibiotic therapy demonstrated the lowest recurrence rates for perianal abscesses in infants.
- The average treatment duration for symptom resolution with antibiotics was short (6 days).
- Antibiotic treatment is recommended as the primary and preferred method for managing and preventing recurrent perianal abscesses in young children.
Background:
Recurrent perirectal abscesses in children under 2 years pose management challenges due to high relapse risks, with limited evidence comparing long-term outcomes of antibiotic therapy versus surgical drainage. This study aimed to compare antibiotic treatment approaches and surgical interventions in managing this condition.
Methods:
This retrospective cohort study analyzed 336 medical records of children under two years old with perianal abscesses treated at Hazrat Masoumeh Children's Hospital from 2012-2019. Patients were divided into three groups: antibiotic treatment only, spontaneous drainage, and incision and drainage. Data, including demographics, abscess characteristics, and treatment outcomes (recurrence, fistula formation), were analyzed using SPSS software version 26.
Results:
A retrospective cohort study of 336 children with perianal abscesses found no significant differences in age, weight, sex, or nutritional status among the three treatment groups (P>0.05). However, statistically significant differences were observed in abscess location (distance from the anus) and size, with the incision and drainage group having larger and more distally located abscesses (P<0.05). Colic was less prevalent in the antibiotic-only group. The spontaneous drainage group had a significantly higher recurrence rate (37%). Antibiotic type distribution was similar across groups. The antibiotic-only group showed symptom resolution within 3-10 days, averaging 6 days.
Conclusion:
In general, according to the lowest rate of recurrence in the group receiving antibiotics and the average duration of short treatment of 6 days, the antibiotic approach is the preferred and primary method for the treatment and prevention of abscess recurrence.
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