June 27, 2017Annals of Surgery
Extended Versus Narrow-spectrum Antibiotics in the Management of Uncomplicated Appendicitis in Children
Key result
Extended-spectrum antibiotics show no benefit over narrow-spectrum antibiotics for preventing pediatric surgical site infections.
- OR 1.05
- 95% CI 0.34-3.26
- n=1,389
Why the study?
There is a paucity of high-quality evidence comparing extended versus narrow-spectrum antibiotics for preventing surgical site infections in children with uncomplicated appendicitis.
Does piperacillin/tazobactam reduce 30-day surgical site infections and hospital revisits compared to narrow-spectrum antibiotics in children with uncomplicated appendicitis?
Population
1389 children undergoing appendectomy for uncomplicated appendicitis at 17 hospitals
Comparison
Extended-spectrum piperacillin/tazobactam vs narrow-spectrum cefoxitin or ceftriaxone with metronidazole
Design
Propensity-matched cohort study
Follow-up
30-day
Authors
Discussion
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Member takes
Implication
Supports narrow-spectrum antibiotics in pediatric appendicitis; leaves open need for randomized confirmation before practice change.
Study Design
Type
Cohort (n=1,389)
Multicenter
Yes
Structured PICO
Does piperacillin/tazobactam reduce 30-day surgical site infections and hospital revisits compared to narrow-spectrum antibiotics in children with uncomplicated appendicitis?
P
Population
1,389 children undergoing appendectomy for uncomplicated appendicitis across 17 hospitals, evaluated for 30-day outcomes.
E
Exposure
Piperacillin/tazobactam (extended spectrum antibiotics)
C
Comparator
Cefoxitin or ceftriaxone with metronidazole (narrow spectrum antibiotics)
O
Outcome
30-day surgical site infection (SSI) and hospital revisit rateshard clinical
Main Result
Odds Ratio: 1.05 (95% CI 0.34–3.26)
Absolute Event Rate: 2.4% vs 1.8%
Extended-spectrum antibiotics do not reduce surgical site infections or hospital revisits compared to narrow-spectrum antibiotics in children with uncomplicated appendicitis.
Cite This Study
Cameron et al. (2017) conducted a cohort in Uncomplicated appendicitis (n=1,389). Extended-spectrum antibiotics (piperacillin/tazobactam) vs. Narrow-spectrum antibiotics (cefoxitin or ceftriaxone with metronidazole) was evaluated on 30-day surgical site infection (SSI) (OR 1.05, 95% CI 0.34-3.26). Extended-spectrum antibiotics were not associated with lower rates of 30-day surgical site infection compared with narrow-spectrum antibiotics in children (2.4% vs 1.8%; OR 1.05, 95% CI 0.34-3.26).