It's Time to Deconstruct Treatment-Failure: A Randomized Controlled Trial of Nonoperative Management of Uncomplicated Pediatric Appendicitis with Antibiotics Alone
Author / Expert
Sofia Perez Otero, Julia W. Metzger, Beatrix H. Choi, Akila Ramaraj, Jun Tashiro, Keith A. Kuenzler, Howard B. Ginsburg, Sandra S. Tomita, Jason C. Fisher
Topic overview
ABSTRACT
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
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