Format

Send to

Choose Destination
J Pediatr Surg. 2015 Sep;50(9):1566-8. doi: 10.1016/j.jpedsurg.2015.04.008. Epub 2015 Apr 25.

A role for conservative antibiotic treatment in early appendicitis in children.

Author information

1
Department of Pediatric Surgery, Meir Medical Center, Kfar Saba, Israel; Tel Aviv University, Tel Aviv, Israel. Electronic address: zvi.steiner@clalit.org.il.
2
Department of Pediatric Surgery, Meir Medical Center, Kfar Saba, Israel; Tel Aviv University, Tel Aviv, Israel.
3
Tel Aviv University, Tel Aviv, Israel; Department of Radiology, Meir Medical Center, Kfar Saba, Israel.

Abstract

PURPOSE:

To evaluate whether antibiotics without surgery is sufficient treatment for children with clinically and ultrasonographically suspected acute appendicitis (AA).

METHOD:

Children with clinical, laboratory and radiological findings suspicious for AA were evaluated prospectively. Patients with mild clinical signs, without peritonitis were considered for IV followed by oral antibiotics without surgery.

RESULTS:

From 1 November 2013 through 30 June 2014, 45 children were diagnosed with early, acute appendicitis. Ages ranged from 4 to 15 years (mean 9.3) and 32 (75%) were boys. All had routine, clinical laboratory and ultrasound workup. Forty-two improved with antibiotic treatment and were discharged home within 3-5 days, without surgery. Three of them were operated on within 24 hours, another two underwent appendectomy for recurrent appendicitis: one at 2 weeks and the other 2 months after discharge. There was no more recurrent appendicitis in 6-14-month follow-up.

CONCLUSION:

Our series of patients with AA treated with antibiotics only are a product of the observation that some children improve with antibiotics alone at a stage in which surgery is still debatable. These results (89% success rate) support the conservative approach in cases of early appendicitis, without increased morbidity in failed cases.

KEYWORDS:

Antibiotics; Appendicitis; Conservative treatment

PMID:
26341885
DOI:
10.1016/j.jpedsurg.2015.04.008
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center