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 .
One-drug versus two-drug antibiotic therapy in pediatric perforated appendicitis: a prospective randomized study.
A prospect i ve r and omized study was undertaken to compare the use of the combination of gentamicin and clindamycin with single agent , cefoxitin , in the treatment of perforated appendicitis in the pediatric patient . In a 3-year period from 1986 to 1989 , 56 patients with perforated appendicitis were r and omized . Twenty-nine patients received cefoxitin , and 27 patients received gentamicin and clindamycin . Antibiotics were started before operation and continued for a minimum of 6 days after operation . Skin and subcutaneous tissues were left open at surgery and closed secondarily after day 3 , if they appeared to be clean . Wounds were considered infected if they developed increased purulence with positive wound cultures . Age range was similar in both groups , with a mean of 9 years ( range , 1 to 17 years ) ; 28 were boys and 28 were girls . No changes in antibiotics were required for reasons of susceptibility . No adverse drug reactions occurred in either group . The most common organisms were Escherichia coli in 35 cases ( 62 % ) and Bacteroides species in 26 cases ( 46 % ) . No difference was noted in infection complications in the two groups nor in length of hospital stay . Therefore , no difference is evident in the use of cefoxitin versus gentamicin and clindamycin in the treatment of perforated appendicitis in terms of disease or drug-related complications
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 .