Switching lanes: No home antibiotics or laboratory testing prior to discharge in perforated appendicitis

Appendicitis is the most common surgical emergency in children with approximately 30 % of patients presenting with perforation, defined as a hole in the appendix or a fecalith found in the abdomen, at time of surgery. Our previous protocol at time of discharge, with an 8 % intra-abdominal abscess (IAA) rate, included checking a white blood cell count (WBC) on day of discharge, with a value ≥ 10 serving as a trigger for additional outpatient oral antibiotics course. Beginning in May, 2023 we changed our protocol to no longer obtain WBC count or prescribe outpatient antibiotics at time of discharge.