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Perforated appendix and antibiotics

M Kekomäki, I Louhimo

    Zeitschrift Fur Kinderchirurgie : Organ Der Deutschen, Der Schweizerischen Und Der Osterreichischen Gesellschaft Fur Kinderchirurgie = Surgery in Infancy and Childhood
    |April 1, 1981
    PubMed

    Insights

    Clindamycin and gentamicin were more effective than penicillin and streptomycin for treating perforated appendicitis in children, leading to fewer and less severe complications. This antibiotic regimen reduced treatment time and hospital stays for pediatric appendicitis patients.

    Area of Science:

    • Pediatric Surgery
    • Infectious Diseases
    • Pharmacology

    Background:

    • Perforated appendicitis in children often leads to severe suppurative complications.
    • Antibiotic selection is crucial for managing pediatric appendicitis outcomes.
    • Previous treatments may not adequately address anaerobic bacterial infections.

    Purpose of the Study:

    • To compare the efficacy of two antibiotic regimens in treating perforated appendicitis in children.
    • To evaluate the incidence and severity of suppurative complications.
    • To assess the impact on hospital stay duration.

    Main Methods:

    • A randomized controlled trial involving 60 children with perforated appendicitis.
    • Group 1: Penicillin and streptomycin.
    • Group 2: Clindamycin and gentamicin.

    Main Results:

    • The clindamycin and gentamicin group experienced fewer and less severe suppurative complications.
    • Hospital days for complications were three times greater in the penicillin and streptomycin group.
    • Bacteroides fragilis was frequently isolated in severe infections not treated with clindamycin.
    • Two patients (2/28) in the clindamycin group developed severe diarrhea.

    Conclusions:

    • Clindamycin and gentamicin offer a superior treatment option for perforated appendicitis in children compared to penicillin and streptomycin.
    • This regimen is associated with reduced complication rates, severity, and healthcare resource utilization.
    • Effective management of anaerobic infections, such as those caused by Bacteroides fragilis, is critical.

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