Piperacillin/tazobactam versus ceftriaxone/metronidazole for children with perforated appendicitis: a systematic review and meta-analysis
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View abstract on PubMed
Summary
This summary is machine-generated.For children with perforated appendicitis, this review found no significant difference in outcomes between piperacillin/tazobactam and ceftriaxone/metronidazole post-operative antibiotics. Further research is needed to determine the optimal antibiotic regimen for pediatric perforated appendicitis.
Area Of Science
- Pediatric Surgery
- Infectious Diseases
- Clinical Pharmacology
Background
- Acute appendicitis is common in children, often treated with surgery and antibiotics.
- Perforated appendicitis requires careful post-operative antibiotic selection.
- Current antibiotic choices for pediatric perforated appendicitis vary.
Purpose Of The Study
- To compare the efficacy and safety of piperacillin/tazobactam versus ceftriaxone and metronidazole as post-operative antibiotics in children with perforated appendicitis.
Main Methods
- Systematic literature search of Medline, Embase, and Cochrane databases.
- Included comparative studies of pediatric perforated appendicitis patients receiving piperacillin/tazobactam or ceftriaxone/metronidazole post-operatively.
- Meta-analysis of outcomes including surgical site infections, imaging, and hospital readmissions.
Main Results
- Four studies (25,730 children) were included: one RCT and three observational studies.
- No significant differences were found between antibiotic groups for deep surgical site infections, post-operative imaging, emergency department returns, or readmissions.
- Substantial heterogeneity was noted across studies, with potential biases in the included RCT and observational studies.
Conclusions
- Current evidence suggests no clear advantage of piperacillin/tazobactam over ceftriaxone/metronidazole for post-operative treatment of perforated appendicitis in children.
- Uncertainty remains regarding the optimal antibiotic strategy.
- Further high-quality research is warranted to guide clinical practice.
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