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04-10-2023 | Antibiotic | Original Article

Antibiotic treatment of post-appendectomy abscesses in children, regardless of size: a twelve years’ experience

Authors: Julio César Moreno-Alfonso, Ada Molina Caballero, Alberto Pérez Martínez

Published in: Updates in Surgery | Issue 8/2023

Abstract

Intra-abdominal abscesses are a common issue after appendectomy. Antibiotics have shown efficacy in treating smaller abscesses, while larger ones have traditionally been treated with drainage. This study assesses the efficacy of antibiotics for post-appendectomy intra-abdominal abscess (PAA) in children regardless of size. Case–control study of children with PAA admitted at our hospital from 2010 to 2022. The efficacy of antibiotics was compared between abscesses less and more than 6 cm in diameter. The Institutional Review Board has approved this study. A total of 1766 appendectomies were performed from 2010 to 2022 with an incidence of PAA of 5% (n = 89): age 9.3 IQR 5.8, 63% male (n = 56). Sixty-seven patients presented with a ≤ 6 cm abscess (controls) and 22 children had a > 6 cm PAA (cases). Length of intravenous antibiotics were higher in cases (15 IQR 7 days) than controls (12 IQR 4 days), p = 0.003. The efficacy of antibiotics in controls was 97% whereas 86.4% in cases (p = 0.094), reoperation was needed in 2/67 controls and 3/22 cases, with no differences in complications or readmission. The length of stay was longer in cases (15 IQR 6 days) than controls (13 IQR 5 days), p = 0.042. Antibiotics seem a safe treatment for PAA in children regardless of the size. However, this approach is associated with a longer period of intravenous antibiotics and hospital stay, although not with a higher rate of therapeutic failure, complications or reoperations.

Graphical abstract

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Title: Antibiotic treatment of post-appendectomy abscesses in children, regardless of size: a twelve years’ experience
Authors: Julio César Moreno-Alfonso
Ada Molina Caballero
Alberto Pérez Martínez
Publication date: 04-10-2023
Publisher: Springer International Publishing
Keywords: Antibiotic
Appendectomy
Appendicitis
Appendicitis
Published in: Updates in Surgery / Issue 8/2023
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-023-01654-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Antibiotic treatment of post-appendectomy abscesses in children, regardless of size: a twelve years’ experience

Abstract

Graphical abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Graphical abstract

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