Perforated Appendix and Antibiotics

Abstract

60 consecutive children operated for perforated appendicitis were treated randomly with either penicillin and streptomycin or with clindamycin and gentamycin. Suppurative complications occurred somewhat more often and were definitely more severe in the former group. The number of hospital days spent in the treatment of these complications were three times as great in the former than in the latter group. Bacteroides fragilis could be isolated in most of the severe infections treated without clindamycin. Two out of 28 patients treated with clindamycin presented with severe diarrhoea.

Aminoglycoside-Based Triple-Antibiotic Therapy Versus Monotherapy for Children With Ruptured Appendicitis

“…[1][2][3] Although intravenous antibiotic therapy is a cornerstone of therapy for perforated appendicitis, the optimal regimen of antibiotics for children remains controversial. Although many physicians would argue that "standard therapy" consists of an aminoglycoside, a ␤-lactam, and an antibiotic with anaerobe coverage (ie, ampicillin, gentamicin, or metronidazole), [4][5][6][7][8][9][10][11][12][13][14][15][16] increasing evidence suggests that single-agent antibiotic therapy provides equivalent results, compared with multiagent regimens. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] In fact, a meta-analysis reviewed 64 randomized, controlled trials comparing ␤-lactam monotherapy with ␤-lactam/aminoglycoside combination therapy for patients with sepsis.…”