Pediatric Appendicitis: Do Extended-Spectrum Antibiotics Offer Better Outcomes?

Extended-spectrum linked to 30-day readmission in complicated, not uncomplicated appendicitis
Extended-spectrum linked to 30-day readmission in complicated, not uncomplicated appendicitis

(HealthDay News) — For children diagnosed with appendicitis undergoing appendectomy, extended-spectrum antibiotics seem to offer no advantage over narrower-spectrum agents, according to a study published online June 28 in Pediatrics.

Matthew P. Kronman, M.D., from the University of Washington in Seattle, and colleagues performed a retrospective cohort study involving children aged 3 to 18 years discharged between 2011 and 2013 with an appendicitis diagnosis and appendectomy performed. Data were included for 24,984 patients.

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The researchers found that 70.7 percent of the patients had uncomplicated appendicitis and 29.3 percent had complicated appendicitis (postoperative length of stay of three or more days, central venous catheter placed, major or severe illness classification, or intensive care unit admission). Overall, 2.7 percent of patients experienced the primary outcome of 30-day readmission for wound infection or repeat abdominal surgery (1.1 and 6.4 percent, respectively, among uncomplicated and complicated cases [P < 0.001]). There was a significant correlation for extended-spectrum antibiotic exposure with the primary outcome in complicated (adjusted odds ratio, 1.43; 95 percent confidence interval, 1.06 to 1.93) but not uncomplicated (adjusted odds ratio, 1.32; 95 percent confidence interval, 0.88 to 1.98) appendicitis.

"Extended-spectrum antibiotics seem to offer no advantage over narrower-spectrum agents for children with surgically managed acute uncomplicated or complicated appendicitis," the authors write.

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