How can the surgeon choose preoperatively the most appropriate antibiotic prophylaxis vs therapy in pediatric acute appendicitis?

Introduction The aim of this study was to find statistically valid criteria to preoperatively divide acute appendicitis into simple and complicated to enable surgeons to administer the most appropriate antibiotic prophylaxis/therapy before surgery. Materials and methods We retrospectively reviewed a...

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Bibliographic Details
Published in:Pediatric surgery international 2024-07, Vol.40 (1), p.170, Article 170
Main Authors: Spampinato, Grazia, Virgillito, Chiara, Ghidini, Filippo, Ceccarelli, Pier Luca
Format: Article
Language:English
Subjects:
Acute Disease
Adolescent
Anti-Bacterial Agents - therapeutic use
Antibiotic Prophylaxis - methods
Antibiotics
Appendectomy
Appendectomy - methods
Appendicitis
Appendicitis - surgery
Child
Child, Preschool
Disease prevention
Female
Generalized linear models
Humans
Infant
Male
Medicine
Medicine & Public Health
Neutrophils
Pediatric Surgery
Pediatrics
Preoperative Care - methods
Retrospective Studies
Review
Surgery
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Summary:Introduction The aim of this study was to find statistically valid criteria to preoperatively divide acute appendicitis into simple and complicated to enable surgeons to administer the most appropriate antibiotic prophylaxis/therapy before surgery. Materials and methods We retrospectively reviewed a cohort of patients who underwent appendectomy from January 2022 to December 2023. Patients included were 0–14 years of age. Exclusion criteria included patients who underwent interval appendectomy or concurrent procedures at the same time of appendectomy. We divided patients into two groups: simple (group S) and complicated (group C) appendicitis according to intraoperative finding. Generalized linear model (GLM) with logit function was developed to identify the predictive variables of the type of appendicitis (S vs C) in terms of CRP value, neutrophils percentage and WBC count adjusted for age and sex of patients. Finally, principal component analysis (PCA) was carried out to identify the cutoff value of statistically significant variables found in the previous analysis. Results One hundred and twenty patients were eligible (N female = 49, N male = 71) for the study. 74 and 46 patients were included in groups S and C, respectively. In a preliminary analysis using univariate and multivariate GLM, only CRP (p value =  
ISSN:1437-9813
0179-0358
1437-9813
DOI:10.1007/s00383-024-05753-6