Peritoneal cultures and antibiotic therapy in pediatric perforated appendicitis

Mosdell, Dale M.; Morris, Don M.; Fry, Donald E.

doi:10.1016/0002-9610(94)90207-0

Cited by 55 publications

(33 citation statements)

References 16 publications

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“…19 Further variation may also reflect differing inclusion/exclusion criteria; for example, exclusion of patients with a non-inflamed appendix 15 or inclusion of only patients with complicated appendicitis. 12 The relatively low overall positive culture rate observed in our series may have been influenced by the ratio of a low proportion of patients with 'complicated' appendicitis, and a relatively high rate of removal of non-inflamed appendices (31%) almost half of which were swabbed. Although the removal of non-inflamed appendices was high, it is similar to the 20-30% negative appendicectomy rates quoted by Jones.…”

Section: Discussionmentioning

confidence: 65%

“…12,15,17,18 This may reflect differences related to the collection and transfer of specimens or the culture techniques employed. In particular, collection techniques and prolonged exposure to oxygen can influence the isolation of anaerobes.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, it has been suggested that the practice of obtaining intra-operative swabs for culture should be abandoned in appendicitis. [10][11][12][13] The aim of this retrospective observational study was to examine the clinical value of intra-operative cultures, by determining the influence of microbiological results on postoperative outcome in patients undergoing appendicectomy.…”

mentioning

confidence: 99%

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Intra-operative culture in appendicitis: traditional practice challenged

Gladman¹,

Knowles²,

Gladman³

et al. 2004

Ann R Coll Surg Engl

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Introduction: Traditionally, microbiological swabs are taken for culture during appendicectomy. However, the pathogens encountered are largely predictable, and sensitive to broad-spectrum antibiotics. Thus, we aimed to examine the clinical value of this practice, by determining the influence of microbiological results on postoperative outcome in patients undergoing appendicectomy. Patients and Methods:The study population comprised 721 consecutive patients undergoing appendicectomy for suspected acute appendicitis in a single district general hospital. Microbiological culture results and sensitivities of isolates were recorded in relation to histopathological findings and infective morbidity, to establish whether they influenced postoperative outcome. Results: Swabs were taken during 463 (64%) appendicectomies. Only 113 (24%) yielded positive cultures ('coliforms', anaerobes and Streptococcus milleri were most frequently isolated). Organisms resistant to broad-spectrum antibiotics were encountered in only 11 of 463 patients (2%) where swabs were taken. Overall, 39 patients (5%) developed significant infective complications postoperatively. Neither the presence of a positive intra-operative culture, nor the isolation of resistant organisms were significant in predicting infective complications (P = 0.11 and 0.17, respectively). Conclusions: In the population studied, the results of intra-operative culture did not influence clinical outcome in patients undergoing appendicectomy. The practice of taking routine microbiological swabs for culture must be seriously questioned.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Intra-operative culture in appendicitis: traditional practice challenged

Gladman¹,

Knowles²,

Gladman³

et al. 2004

Ann R Coll Surg Engl

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“…[11][12][13] In our study, nonspecific perforations accounted for 52% of small bowel reported in literature. 1,3,23,28 The most important reason could be the delay in presentation. Instituting appropriate antibiotics at later stages may be ineffective.…”

Section: Discussionmentioning

confidence: 99%

Community acquired secondary bacterial peritonitis in a tertiary hospital of South India: an audit with special reference to peritoneal fluid culture

Vpm

Chandramaliteeswaran²,

Dharanipragadha³

et al. 2012

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“…The most common isolates are Escherichia coli, Bacteroides fragilis, Peptostreptococcus, and Pseudomonas species. [11][12][13] As inflammation spreads to the parietal peritoneum, pain typically localizes to the right lower quadrant. For unknown reasons, this classic migration of pain is not observed in more than one quarter of adult and one third of pediatric cases.…”

Section: Introductionmentioning

confidence: 99%

Prospective Evaluation of Clinical and USG Findings of Acute Appendicitis at a Tertiary Care Teaching Hospital

Kumar¹,

Tyagi²

2016

IJMRP

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Introduction: Acute appendicitis is one of the commonest surgical emergencies requiring surgery in both adults and children. The overall frequency of appendicitis for symptomatic patients younger than 20 years is 41%; the frequency for those older than 20 years is 59%. Present study was conducted in clinical cases representing the inflamed appendix cases. Various positions of appendix in patients with appendicitis and also the clinical picture, radiology investigations, intra operative findings and histopathology was studied. Materials & Methods: Present study was a prospective, observational study carried out in Department of Surgery, Saraswathi Institute of Medical Sciences, Anwarpur, Hapur, Uttar Pradesh, India. 60 cases were included in study on the basis of inclusion and exclusion criteria and subjected to clinical assessment using signs, symptoms and laboratory criteria, histopathology and also the position of the appendix, which were recorded in the proforma. Results: 60 patients were included in present study; among them 37 were males and 23 were females. Appendicitis was more common during the 3rd decade of life -25 cases (41.7%), followed by the 4th decade-14 cases (23.3%). Overall sensitivity of 91.1% was detected in cases of retrocaecal appendicitis. On comparing the position of appendix with USG and intra operative findings; USG has sensitivity of 91.9% in retrocaecal type followed by 90.9% in detection of pelvic type. Conclusions: As evidenced by high misdiagnosis and perforation rates of appendicitis, the diagnosis of appendicitis

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Peritoneal cultures and antibiotic therapy in pediatric perforated appendicitis

Cited by 55 publications

References 16 publications

Intra-operative culture in appendicitis: traditional practice challenged

Intra-operative culture in appendicitis: traditional practice challenged

Community acquired secondary bacterial peritonitis in a tertiary hospital of South India: an audit with special reference to peritoneal fluid culture

Prospective Evaluation of Clinical and USG Findings of Acute Appendicitis at a Tertiary Care Teaching Hospital

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