Treatment of pediatric suppurative mastoiditis: is peripherally inserted central catheter (PICC) antibiotic therapy necessary?

Otolaryngol Head Neck Surg. 2006 Jul;135(1):106-10. doi: 10.1016/j.otohns.2006.02.016.

Abstract

Objective: A review of the treatment of pediatric acute mastoiditis requiring surgical intervention managed with and without PICC therapy postoperatively.

Study design and setting: Retrospective study of 42 cases from 1989 to 2004 treated at a regional children's hospital.

Results: Sixteen patients received postoperative PICC therapy and 26 received a course of oral antibiotics. The PICC group received on average 12.12 days of intravenous antibiotics compared to only 3.53 days for the non-PICC group (P < 0.001). No differences were observed between the two groups in treatment outcomes. One patient from each group required rehospitalization. One minor complication was experienced in a patient in the PICC group. There were no surgical complications. The total cost for outpatient PICC therapy increased treatment costs by approximately $1500 to $2500.

Conclusions: Oral antibiotic therapy is sufficient after surgical intervention for acute pediatric suppurative mastoiditis without intracranial complications and does not result in adverse treatment outcome.

Significance: Use of PICC therapy after surgical intervention for mastoiditis should be limited.

Ebm rating: B-3b.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Acute Disease
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / economics
  • Catheterization, Peripheral*
  • Child, Preschool
  • Cost-Benefit Analysis
  • Female
  • Follow-Up Studies
  • Humans
  • Injections, Intravenous
  • Male
  • Mastoiditis / drug therapy*
  • Mastoiditis / surgery
  • Postoperative Care
  • Retrospective Studies
  • Suppuration / drug therapy
  • Suppuration / surgery
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents