It's Time to Deconstruct Treatment-Failure: A Randomized Controlled Trial of Nonoperative Management of Uncomplicated Pediatric Appendicitis with Antibiotics Alone
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Read the article on jpedsurg.org ↗Article · Sep 2021 · 1 min read
In brief
In brief
Randomized controlled trial comparing antibiotics-alone versus appendectomy for uncomplicated pediatric appendicitis in patients aged 6-17 years. Study protocol uses IV piperacillin/tazobactam followed by oral ciprofloxacin/metronidazole to validate nonoperative management and identify factors contributing to treatment failure.
Written by the GCMD Library team from the article.
Background
: Published data demonstrate that management of uncomplicated pediatric appendicitis with antibiotics-alone is safe and frequently successful. Randomized controlled trials (RCT) comparing antibiotics-alone to appendectomy are lacking, alongside insight into drivers of failure. We sought to validate the antibiotics-alone approach and identify barriers to success using an RCT design.
Methods
: Patients aged 6-17 years with uncomplicated appendicitis were randomized to appendectomy or intravenous piperacillin/tazobactam for 24–48 hours followed by 10 days of oral ciprofloxacin/metronidazole. Enrollment required symptoms