Ceftriaxone Combined With Metronidazole is Superior to Cefoxitin Alone in the Management of Uncomplicated Appendicitis in Children: Results from a Multicenter Collaborative Comparative Effectiveness Study

Annals of Surgery
Mark A KashtanShawn J Rangel

Abstract

To compare rates of surgical site infection between the 2 most commonly utilized narrow-spectrum antibiotic regimens in children with uncomplicated appendicitis (ceftriaxone with metronidazole and cefoxitin alone). Narrow-spectrum antibiotics have been found to be equivalent to extended-spectrum (antipseudomonal) agents in preventing surgical site infection (SSI) in children with uncomplicated appendicitis. The comparative effectiveness of different narrow-spectrum agents has not been reported. This was a multicenter retrospective cohort study using clinical data from the Pediatric National Surgical Quality Improvement Program Appendectomy Collaborative Pilot database merged with antibiotic utilization data from the Pediatric Health Information System database from January 2013 to June 2015. Multivariable logistic regression was used to compare outcomes between antibiotic treatment groups after adjusting for patient characteristics, surrogate measures of disease severity, and clustering of outcomes within hospitals. Eight hundred forty-six patients from 14 hospitals were included in the final study cohort with an overall SSI rate of 1.3%. A total of 56.0% of patients received ceftriaxone with metronidazole (hospital range: 0%-1...Continue Reading

References

Feb 1, 1975·Antimicrobial Agents and Chemotherapy·F P TallyS L Gorbach
Feb 1, 1976·Journal of Pediatric Surgery·H H Stone
Feb 1, 1993·The Journal of Antimicrobial Chemotherapy·D I Edwards
Jul 1, 1997·The American Journal of Medicine·J D PitoutW E Sanders
Dec 4, 2004·Nature Medicine·Stuart B Levy, Bonnie Marshall
Dec 16, 2005·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Sara E Cosgrove
Sep 11, 2009·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Rebecca R RobertsRobert A Weinstein
Jan 14, 2010·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Sonja LöfmarkCarl Erik Nord
Nov 3, 2010·Journal of the American College of Surgeons·Mehul V RavalUNKNOWN ACS NSQIP Pediatric Steering Committee
Jan 18, 2011·Journal of Pediatric Surgery·Mehul V RavalUNKNOWN ACS NSQIP Pediatric Steering Committee
Jun 16, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Matthew J NeidellElaine L Larson
Jul 5, 2012·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Dror MarchaimKeith S Kaye
Jan 22, 2013·Journal of Pediatric Surgery·Jennifer L BrunyMoritz M Ziegler
Nov 15, 2013·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Jeffrey S GerberTheoklis E Zaoutis
Jun 23, 2016·Cold Spring Harbor Perspectives in Medicine·Karen Bush, Patricia A Bradford
Jun 30, 2016·Pediatrics·Matthew P KronmanJeffrey S Gerber

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Citations

Aug 5, 2021·Pediatric Quality & Safety·Martha-Conley E IngramMehul V Raval
Aug 15, 2021·Advances in Surgery·Katherine He, Shawn J Rangel

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