J Korean Assoc Pediatr Surg.  2015 Dec;21(2):28-31. 10.13029/jkaps.2015.21.2.28.

Postoperative Monotherapy with Piperacillin-Tazobactam versus Multidrug Therapy with Cefotaxime and Metronidazole for Perforated Appendicitis in Children: A Case-Control Study

Affiliations
  • 1Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 2Division of Pediatric Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. kimdy@amc.seoul.kr

Abstract

PURPOSE
Recent data suggest that monotherapy with a broad-spectrum antibiotic may be as efficacious as, and potentially less costly than, standard multi-drug therapy. We compared mono-therapy with intravenous piperacillin-tazobactam (PT) with multi-drug therapy with cefotaxime and metronidazole (CM) in aspect of postoperative complications and hospital stay.
METHODS
We reviewed the hospital records and medical costs of the pediatric patients who were managed for perforated appendicitis between April 2013 and May 2014 retrospectively.
RESULTS
Forty-six patients with laparoscopic appendectomy for perforated appendicitis were included in our study. PT group was 20 and CM group was 26 patients. On admission, there were no significance in sex distribution, duration of symptoms, leukocyte count, and CRP levels. At postoperative third, fifth, and seventh day of each regimen, PT group have no statistical difference with CM group in leukocyte count, percentage of neutrophil, and CRP. There was no difference in abscess formation rate, wound infections, and hospital stay between two groups. There was only one patient who was readmitted with elevation of CRP and leukocyte count in CM group.
CONCLUSION
Daily dosing with the mono-therapy of PT offers as efficient as multi-drug therapy of CM. To evaluate the efficacy of broad-spectrum antibiotics monotherapy in perforated appendicitis children, the cohort included more patients should be needed.

Keyword

Appendicitis; Piperacillin-tazobactam monotherapy; Cefotaxime; Metronidazole

MeSH Terms

Abscess
Anti-Bacterial Agents
Appendectomy
Appendicitis*
Case-Control Studies*
Cefotaxime*
Child*
Cohort Studies
Hospital Records
Humans
Length of Stay
Leukocyte Count
Metronidazole*
Neutrophils
Postoperative Complications
Retrospective Studies
Sex Distribution
Wound Infection
Anti-Bacterial Agents
Cefotaxime
Metronidazole
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