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[Appendicular peritonitis: antibiotics and complications (author's transl)]
Insights
Two antibiotic policies for pediatric appendicitis showed no difference in septic complications but reduced intraabdominal abscesses compared to older methods. Wound infection rates remained unchanged.
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.
Abstract:
A retrospective study of the complications and bacteriologic findings in a group of 500 appendectomies in children under seven years is reported. A prospective trial on 64 appendiceal peritonitis revealed that there were no significant differences between two antibiotic policies (clindamycin plus gentamycin vs. cefoxitine alone) in regard to postoperative septic complications. Nevertheless, both policies significantly decreased the number of intraabdominal abscesses as compared with the treatments applied during the years of the retrospective study. No improvement was observed in the number of wound infections.