Initial antibiotic treatment for acute simple appendicitis in children is safe: Short-term results from a multicenter, prospective cohort study
| Autor: | Pierre M. Bet, Hugo A. Heij, S. van Veen, Martin Offringa, Klaas H. in 't Hof, Johanna H. van der Lee, Jaap Bonjer, Marc A. Benninga, Y. Acherman, Peter M. N. Y. H. Go, R.R. van Rijn, F. Galindo, Doranne L. Hilarius, N. Ahmadi, Ramon R. Gorter, C. M. Frank Kneepkens, Huibert A. Cense, Marc H. W. A. Wijnen |
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| Přispěvatelé: | APH - Amsterdam Public Health, General Paediatrics, Paediatric Surgery, Radiology and Nuclear Medicine, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Paediatric Gastroenterology, Pediatric surgery, Pediatrics, CCA - Innovative therapy |
| Rok vydání: | 2015 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Adolescent medicine.drug_class Antibiotics Pilot Projects Amoxicillin-Potassium Clavulanate Combination law.invention Randomized controlled trial law Clavulanic acid medicine Appendectomy Humans Prospective Studies Child Adverse effect Prospective cohort study business.industry Other Research Radboud Institute for Health Sciences [Radboudumc 0] Amoxicillin Appendicitis medicine.disease Clinical trial Female Surgery Gentamicins beta-Lactamase Inhibitors business medicine.drug |
| Zdroj: | Surgery, 157(5), 916-923. Mosby Inc. Surgery, 157, 5, pp. 916-23 Gorter, R R, van der Lee, J H, Cense, H A, Kneepkens, C M F, Wijnen, M H W A, in't Hof, K H, Offringa, M & Heij, H A 2015, ' Initial antibiotic treatment for acute simple appendicitis in children is safe: Short-term results from a multicenter, prospective cohort study ', Surgery, vol. 157, no. 5, pp. 916-923 . https://doi.org/10.1016/j.surg.2015.01.008 Surgery, 157, 916-23 |
| ISSN: | 0039-6060 |
| DOI: | 10.1016/j.surg.2015.01.008 |
| Popis: | Item does not contain fulltext BACKGROUND: Initial antibiotic treatment for acute appendicitis has been shown to be safe in adults; so far, not much is known about the safety and efficacy of this treatment in children. The aims of this study were to investigate the feasibility of a randomized controlled trial (RCT) evaluating initial antibiotic treatment for acute appendectomy in children with acute simple appendicitis and to evaluate the safety of this approach. METHODS: In a multicenter, prospective cohort study patients aged 7-17 years with a radiologically confirmed simple appendicitis were eligible. Intravenous antibiotics (amoxicillin/clavulanic acid 250/25 mg/kg 4 times daily; maximum 6,000/600 mg/d and gentamicin 7 mg/kg once daily) were administered for 48-72 hours. Clinical reevaluation every 6 hours, daily blood samples, and ultrasound follow-up after 48 hours was performed. In case of improvement after 48 hours, oral antibiotics were given for a total of 7 days. At any time, in case of clinical deterioration or non-improvement after 72 hours, an appendectomy could be performed. Follow-up continued until 8 weeks after discharge. Adverse events were defined as major complications of antibiotic treatment, such as allergic reactions, perforated appendicitis, and recurrent appendicitis. RESULTS: Of 44 eligible patients, 25 participated (inclusion rate, 57%; 95% CI, 42%-70%). Delayed appendectomy was performed in 2, and the other 23 were without symptoms at the 8 weeks follow-up. Minor complications occurred in three patients. None of the patients suffered from an adverse event or a recurrent appendicitis. CONCLUSION: Our study shows that an RCT comparing initial antibiotic treatment strategy with urgent appendectomy is feasible in children; the intervention seems to be safe. |
| Databáze: | OpenAIRE |
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