Switching lanes: No home antibiotics or laboratory testing prior to discharge in perforated appendicitis
Author / Expert
Seth Saylors, Cory Nonnemacher, Meredith Elman, Pablo Aguayo, Richard Hendrickson, Irene Isabel P. Lim, Rebecca Rentea, Charles Snyder, Shawn St Peter, Tolulope Oyetunji
Topic overview
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.
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