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Published on: July 24, 2021

Comparison of Two Antibiotic Combinations for Conservative Treatment of Non-Complicated Appendicitis in Children

Mohit Kakar1,2, Georgijs Kulibaba3, Zahraa Merchant3

  • 1Department of Pediatric Surgery, Children's Clinical University Hospital, Vienibas Gatve, 45, LV-1004 Riga, Latvia.

Medicina (Kaunas, Lithuania)
|July 28, 2026
PubMed

Insights

Two antibiotic regimens for acute appendicitis in children showed similar effectiveness in reducing inflammation and comparable clinical outcomes. This suggests either treatment can be used interchangeably in pediatric appendicitis management.

Area of Science:

  • Pediatric Surgery
  • Infectious Diseases
  • Clinical Pharmacology

Background:

  • Acute appendicitis is a common pediatric surgical emergency.
  • Appendectomy is the traditional treatment, but non-operative management with antibiotics is gaining traction.
  • Antibiotic therapy may offer a lower complication risk compared to surgery.

Purpose of the Study:

  • To compare the effectiveness of two distinct antibiotic regimens for acute appendicitis in children.
  • To evaluate antibacterial strategies using inflammatory markers and clinical outcomes.
  • To assess the recurrence rate of appendicitis after antibiotic treatment over one year.

Main Methods:

  • A randomized study involving 41 children (aged 7-18 years) with acute appendicitis.
  • Two treatment groups received either ceftazidime/metronidazole or ampicillin/metronidazole.
  • Inflammatory markers (leukocyte count, C-reactive protein, IL-6, IL-8, MCP-1) were measured over three days.

Main Results:

  • No statistically significant differences in inflammatory markers were observed between the two antibiotic groups.
  • Both regimens demonstrated comparable effectiveness in managing acute appendicitis.
  • Recurrence rates were assessed over a one-year follow-up period.

Conclusions:

  • Both ceftazidime/metronidazole and ampicillin/metronidazole are effective treatments for acute appendicitis in children.
  • The choice between these two antibiotic regimens can be based on clinical judgment and availability.
  • Non-operative management with antibiotics presents a viable alternative to surgery for pediatric appendicitis.

Keywords:
IL6IL8MCP1antibioticsappendicitischildrenconservative treatmentinflammation

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