TY - JOUR
T1 - Comparison of two antibiotic regimens in the treatment of perforated appendicitis in pediatric patients
AU - Rodriguez, J. C.
AU - Buckner, D.
AU - Schoenike, S.
AU - Gomez-Marin, O.
AU - Oiticica, C.
AU - Thompson, W. R.
PY - 2000/1/1
Y1 - 2000/1/1
N2 - Background and purpose: An increased incidence of post-surgical infectious complications in children admitted with a diagnosis of perforated appendicitis led to development of a disease-specific antibiogram and modification of our post-operative antibiotic regimen. Methods: A historical control group comprised of 32 pediatric patients receiving ampicillin, gentamicin, and clindamycin (group AGC) was compared to a cohort of 32 children receiving ticarcillin/clavulanate plus gentamicin (group TG). The surgical procedure, peri-operative management, and inclusion, exclusion and discharge criteria were the same for each group. Outcome measures including length of stay, time to defervesce, incidence of infectious complications, and clinical failures to the antibiotic regimen were compared. Results: The groups were similar with respect to gender, age, weight, surgical time, pre-operative leukocytes, and number of intra-operative bacterial isolates cultured per patient. Length of stay was 10.1 days in group TG and 12.5 days for group AGC (p = 0.0197). The number of clinical failures was reduced from 9 (28.1%) to 2 (6.3%) in group TG (p = 0.02). The time to defervesce was decreased by 1.4 days, and the number of infectious complications was reduced to 2.5-fold in group TG patients. Conclusions: Ticarcillin/clavulanate plus gentamicin was clinically more effective than ampicillin, gentamicin, and clindamycin combination therapy in the management of perforated appendicitis in our pediatric population.
AB - Background and purpose: An increased incidence of post-surgical infectious complications in children admitted with a diagnosis of perforated appendicitis led to development of a disease-specific antibiogram and modification of our post-operative antibiotic regimen. Methods: A historical control group comprised of 32 pediatric patients receiving ampicillin, gentamicin, and clindamycin (group AGC) was compared to a cohort of 32 children receiving ticarcillin/clavulanate plus gentamicin (group TG). The surgical procedure, peri-operative management, and inclusion, exclusion and discharge criteria were the same for each group. Outcome measures including length of stay, time to defervesce, incidence of infectious complications, and clinical failures to the antibiotic regimen were compared. Results: The groups were similar with respect to gender, age, weight, surgical time, pre-operative leukocytes, and number of intra-operative bacterial isolates cultured per patient. Length of stay was 10.1 days in group TG and 12.5 days for group AGC (p = 0.0197). The number of clinical failures was reduced from 9 (28.1%) to 2 (6.3%) in group TG (p = 0.02). The time to defervesce was decreased by 1.4 days, and the number of infectious complications was reduced to 2.5-fold in group TG patients. Conclusions: Ticarcillin/clavulanate plus gentamicin was clinically more effective than ampicillin, gentamicin, and clindamycin combination therapy in the management of perforated appendicitis in our pediatric population.
KW - Ampicillin
KW - Antimicrobial therapy
KW - Clindamycin
KW - Escherichia coli
KW - Gentamicin
KW - Pediatrics
KW - Perforated appendicitis
KW - Pseudomonas aeruginosa
KW - Ticarcillin/ clavulanate
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U2 - 10.5414/CPP38492
DO - 10.5414/CPP38492
M3 - Article
C2 - 11073291
AN - SCOPUS:0033782913
VL - 38
SP - 492
EP - 499
JO - International Journal of Clinical Pharmacology and Therapeutics
JF - International Journal of Clinical Pharmacology and Therapeutics
SN - 0946-1965
IS - 10
ER -