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[Postoperative chemotherapy of perforating appendicitis in children; with special reference to latamoxef therapy]
Insights
Latamoxef (LMOX) effectively treated pediatric appendicitis, including gangrenous and perforated cases, with high clinical efficacy and bacterial eradication rates. The antibiotic demonstrated a favorable safety profile with minimal side effects.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Pharmacology
Context:
- Appendicitis is a common surgical emergency in children.
- Antibiotic therapy plays a crucial role in managing appendicitis, particularly complicated cases.
- Latamoxef (LMOX) is a cephalosporin antibiotic with broad-spectrum activity.
Purpose:
- To evaluate the efficacy and safety of latamoxef (LMOX) in pediatric patients undergoing appendectomy.
- To assess LMOX's effectiveness in different types of appendicitis: catarrhal, gangrenous, and perforated.
- To determine the microbiological eradication rate and identify potential side effects of LMOX therapy.
Summary:
- Latamoxef (LMOX) was administered to pediatric appendicitis patients post-surgery at 50 mg/kg/day (catarrhal/gangrenous) or 90 mg/kg/day (perforated).
- Excellent recovery was observed in catarrhal and gangrenous appendicitis cases.
- High clinical efficacy (92.3%) and bacterial eradication (97.2%) were achieved in perforated appendicitis.
- LMOX showed a good safety profile with only one case of transient diarrhea and no significant laboratory abnormalities.
Impact:
- Latamoxef (LMOX) is a viable and effective antibiotic option for pediatric appendicitis management.
- The study supports the use of LMOX in reducing complications and improving outcomes in pediatric appendicitis.
- Findings contribute to evidence-based guidelines for antibiotic selection in pediatric surgical infections.
Abstract:
We employed latamoxef (LMOX) as antibiotic therapy subsequent to the performance of appendectomies in children. Fifteen patients, consisting of 8 cases of catarrhal appendicitis and 7 cases of gangrenous appendicitis, were administered LMOX at 50 mg/kg/day, while 13 patients with peritonitis due to a perforated appendix were treated with a dosage of 90 mg/kg/day. Both of these dosages were administered in 3 equally-divided doses, as one shot intravenous injections. All of the cases of catarrhal and gangrenous appendicitis showed good, steady recovery after the surgery, and there were no instances of complications. With regard to the 13 cases of perforating appendicitis, a clinical efficacy of at least "good" was obtained in 12 patients, for an efficacy rate of 92.3%. In addition, bacteriologically, 35 out of 36 strains that were isolated initially could no longer be detected after the LMOX therapy, indicating an eradication rate of 97.2%. Complications consisted of 1 case of dehiscence of the wound, and 1 case of adhesive ileus. Comparison of the values of the laboratory tests before and after the LMOX therapy revealed no development of abnormalities. Moreover, with regard to side effects, with the exception of 1 case of transient diarrhea, there were no side effects which presented clinical problems. It was found that the causative microbes involved in these cases of appendicitis--especially in the perforative appendicitis cases--were Gram-negative bacilli such as E. coli, and an anaerobic bacterium, B. fragilis.(ABSTRACT TRUNCATED AT 250 WORDS)