Purpose

Acute appendicitis is one of the commonest surgical emergencies in pediatrics. Treatment usually consists of a combination of surgery and antibiotics. The present study was designed to assess compliance with our local antibiotic protocol and analyse the consequences of non-compliance.

Methods

Children presenting with acute appendicitis between 2015 and 2017 were included in this study. The diagnosis of acute appendicitis was confirmed during surgery. Data concerning the antibiotic therapy received and infectious complications were reviewed.

Results

A total of 142 children with acute appendicitis were included. Antibiotic therapy complied with the protocol in 27.4% of cases, while an excessive duration of antibiotic therapy was observed in 65% of cases. A total of 270 days of non-recommended antibiotic therapy was noted; 32% of patients received a non-recommended combination of antibiotics. The infectious complications rate was 12.8% in the group of patients receiving appropriate antibiotic therapy, and 11.6% in the group with non-compliance to the protocol. No statistically significant difference between the groups was found (P = 0.85).

Conclusion

Poor compliance with the antibiotic guidelines for appendicitis resulted in antibiotic overuse with no benefit in terms of anti-infective efficacy. Better information for the medical team and repeated evaluation of our practices are essential.

中文翻译：

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小儿急性阑尾炎的抗生素治疗：遵守当地法规以减少抗生素过度使用。

目的

急性阑尾炎是儿科中最常见的外科急症之一。治疗通常包括外科手术和抗生素的组合。本研究旨在评估对我们当地抗生素方案的依从性并分析不依从的后果。

方法

这项研究纳入了2015年至2017年期间患有急性阑尾炎的儿童。手术期间证实了急性阑尾炎的诊断。回顾了有关抗生素治疗和感染并发症的数据。

结果

总共包括142例急性阑尾炎儿童。27.4％的病例符合抗生素治疗方案，而65％的病例观察到抗生素治疗时间过长。总共记录了270天的非推荐抗生素治疗；32％的患者接受了不推荐的抗生素组合。接受适当抗生素治疗的患者中，感染并发症的发生率为12.8％，而未遵守治疗方案的患者中则为11.6％。两组之间无统计学差异（P  = 0.85）。

结论

对阑尾炎抗生素指南的依从性差导致抗生素过度使用，在抗感染功效方面没有益处。为医疗团队提供更好的信息以及对我们的做法进行反复评估至关重要。