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 in Pediatrics.

Matthew P. Kronman, MD, 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.

The researchers found that 70.7% of the patients had uncomplicated appendicitis and 29.3% 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% of patients experienced the primary outcome of 30-day readmission for wound infection or repeat abdominal surgery (1.1 and 6.4%, 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.


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“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.

Reference

1. Kronman MP, Oron AP, Ross Rk, et al. Extended- Versus Narrower-Spectrum Antibiotics for Appendicitis. Pediatrics. 2016; doi: 10.1542/peds.2015-4547