Postoperative Antibiotics, Outcomes, and Resource Use in Children With Gangrenous Appendicitis
Topic overview
Multi-center retrospective study examining whether postoperative antibiotics reduce surgical site infections in children with gangrenous appendicitis. Analysis of 16-hospital NSQIP data explores infection rates, resource utilization, and antimicrobial stewardship implications for nonperforated appendicitis with gangrenous findings.
Key takeaways
- Postoperative antibiotics do not reduce SSI rates in children with gangrenous nonperforated appendicitis (1.5% vs 2.0%, p=0.70)
- Wide practice variation exists: hospital postop antibiotic use ranged 32-100% despite lack of outcome benefit
- Gangrenous/suppurative/exudative findings alone do not justify extended antibiotics if appendix is nonperforated
- Propensity-matched analysis of 958 children found no correlation between antibiotic duration and infection-adjusted outcomes
- Antimicrobial stewardship opportunity: discontinue postop antibiotics for nonperforated appendicitis regardless of GSE findings
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