There was no consistency among the protocol s regarding length of antibiotic use , discharge criteria , or use of home antibiotics following discharge .
Limiting duration of antibiotic use to3 days did not appear to be associated with higher rates of intraabdominal abscess or wound infection .
In the absence of higher-level evidence , shortening of antibiotic regimens following surgery for pediatric complicated appendicitis appears to be safe
The suitable duration of antibiotic use following appendectomy for advanced appendicitis in children is still debated .
Acute appendicitis in children.
A prospect i ve study was conducted on 344 children aged from 3 months to 16 years with acute appendicitis . Most children presented with typical features of acute appendicitis ( 70 % ) or peritonitis ( 28 % ) . Atypical presentation was uncommon and occurred only in seven young children , masquerading as intestinal obstruction , gastroenteritis or urinary tract infection . Prolonged delay in surgery was associated with a rise in incidence of late appendicitis ( gangrenous and perforated appendicitis ) . This rise was especially marked 37 h after onset of symptoms . The main causes of delay were inability of the parents and primary care medical practitioners to recognize the disease early . Surgeons contributed very little to the delay . High risk factors for postappendectomy sepsis were young children under 6 years old , late appendicitis , obese patients , inferior systemic antibiotic regimes and inexperienced surgeons . Young children had high postoperative sepsis mainly because of the high incidence of late appendicitis due to their inability to express their symptoms properly . They were not especially prone to postappendectomy sepsis ; they had the same degree of appendicitis compared with older children . Measures to decrease the postappendectomy morbidity are suggested
There was no consistency among the protocol s regarding length of antibiotic use , discharge criteria , or use of home antibiotics following discharge .
Limiting duration of antibiotic use to3 days did not appear to be associated with higher rates of intraabdominal abscess or wound infection .
In the absence of higher-level evidence , shortening of antibiotic regimens following surgery for pediatric complicated appendicitis appears to be safe
The suitable duration of antibiotic use following appendectomy for advanced appendicitis in children is still debated .