A role for conservative antibiotic treatment in early appendicitis in children

Journal of Pediatric Surgery
Zvi SteinerIlan Erez

Abstract

To evaluate whether antibiotics without surgery is sufficient treatment for children with clinically and ultrasonographically suspected acute appendicitis (AA). Children with clinical, laboratory and radiological findings suspicious for AA were evaluated prospectively. Patients with mild clinical signs, without peritonitis were considered for IV followed by oral antibiotics without surgery. From 1 November 2013 through 30 June 2014, 45 children were diagnosed with early, acute appendicitis. Ages ranged from 4 to 15 years (mean 9.3) and 32 (75%) were boys. All had routine, clinical laboratory and ultrasound workup. Forty-two improved with antibiotic treatment and were discharged home within 3-5 days, without surgery. Three of them were operated on within 24 hours, another two underwent appendectomy for recurrent appendicitis: one at 2 weeks and the other 2 months after discharge. There was no more recurrent appendicitis in 6-14-month follow-up. Our series of patients with AA treated with antibiotics only are a product of the observation that some children improve with antibiotics alone at a stage in which surgery is still debatable. These results (89% success rate) support the conservative approach in cases of early appendicitis...Continue Reading

References

May 15, 2003·Seminars in Ultrasound, CT, and MR·Jong Hwa Lee
Mar 16, 2004·Journal of Pediatric Surgery·Dani YardeniArnold G Coran
Aug 21, 2007·Journal of Pediatric Surgery·Musa AbeşSelçuk Kazil
May 1, 2008·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·J Christian FoxKasra Maasumi
Jun 6, 2008·Journal of Pediatric Hematology/oncology·Verena A WiegeringJean-Pierre Bourquin
Oct 16, 2008·Seminars in Ultrasound, CT, and MR·Michele A Brown
Nov 7, 2009·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Michael B Stone, Jennifer Chao
Sep 22, 2010·Archives of Surgery·Angela M IngrahamAvery B Nathens
Nov 3, 2010·Journal of Pediatric Surgery·Steven L LeeUNKNOWN 2010 American Pediatric Surgical Association Outcomes and Clinical Trials Committee
Apr 12, 2011·European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [et Al] = Zeitschrift Für Kinderchirurgie·I GendelI Erez
Jun 22, 2014·Journal of the American College of Surgeons·Peter C MinneciKatherine J Deans

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Citations

Oct 16, 2016·Pediatric Surgery International·Rebecca M RenteaCharles L Snyder
Mar 18, 2017·Current Opinion in Pediatrics·Joseph J LópezPeter C Minneci
Nov 18, 2017·Journal of Paediatrics and Child Health·Andrew ReadJonathan Karpelowsky
Oct 27, 2017·Archives of Disease in Childhood·Nigel J Hall, Simon Eaton
Jan 19, 2018·Pediatric Surgery International·Zvi SteinerShmuel Arnon
Dec 6, 2018·The Journal of Trauma and Acute Care Surgery·David A TalanGregory J Moran
May 30, 2019·Journal of Comparative Effectiveness Research·Le-Wee BiHua-Lei Cui
Dec 16, 2019·Pediatric Surgery International·Sonia MaitaTomas Wester
Feb 18, 2017·European Journal of Pediatrics·Zvi SteinerShmuel Arnon
Dec 21, 2019·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Michiaki IkegamiAtsuyuki Yamataka
Aug 2, 2017·Pediatrics·Richard G BachurMichael C Monuteaux

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