[Appendicular peritonitis: antibiotics and complications (author's transl)]

Area of Science:

• Pediatric Surgery
• Infectious Diseases
• Clinical Trials

Background:

• Appendectomy is a common pediatric surgical procedure.
• Appendiceal peritonitis presents significant management challenges.
• Antibiotic strategies are crucial in managing appendicitis complications.

Purpose of the Study:

• To compare the efficacy of two distinct antibiotic regimens in treating pediatric appendiceal peritonitis.
• To evaluate the impact of modern antibiotic policies on postoperative septic complications and abscess formation.
• To assess changes in wound infection rates following appendectomy.

Main Methods:

• A retrospective analysis of 500 pediatric appendectomies was conducted.
• A prospective trial involving 64 cases of appendiceal peritonitis compared two antibiotic policies: clindamycin plus gentamicin versus cefoxitin.
• Outcomes measured included postoperative septic complications, intraabdominal abscesses, and wound infections.

Main Results:

• No significant difference in postoperative septic complications was observed between clindamycin/gentamicin and cefoxitin monotherapy.
• Both antibiotic policies demonstrated a significant reduction in intraabdominal abscesses compared to historical treatments from the retrospective study.
• There was no observed improvement in the incidence of surgical wound infections.

Conclusions:

• Modern antibiotic regimens effectively reduce intraabdominal abscesses in pediatric appendicitis.
• Current antibiotic strategies do not significantly alter the rate of wound infections in pediatric appendectomies.
• Further research may be warranted to optimize wound infection prevention in this population.