Postoperative antibiotics may not improve outcomes among kids with nonperforated appendicitis with gangrenous, suppurative, or exudative findings: JAMA

This research included a total of 958 children with nonperforated appendicitis in the hospital-level analysis, with 573 (59.8%) receiving postoperative antibiotics. No correlation was found between the use of postoperative antibiotics and SSI rates when analyzed at hospital and patient levels.

The hospital-level analysis explored the association between postoperative antibiotic use and SSI rate ratios and found no significant correlation regardless of the overall rate of antibiotic use or the duration of antibiotic treatment.

Further analysis at the patient level included 404 patients who were propensity-matched who showed similar rates of SSI between those who received postoperative antibiotics and those who did not.

These findings suggest that the postoperative antibiotics use may not provide any added benefit in preventing SSIs in children with nonperforated appendicitis showing GSE findings. Furthermore, unnecessary antibiotic use contributes to antibiotic resistance and the risk of adverse reactions which highlights the importance of evidence-based approaches to prescribe antibiotics.

Reference:

Cramm, S. L., Graham, D. A., Blakely, M. L., Kunisaki, S. M., Chandler, N. M., Cowles, R. A., Feng, C., He, K., Russell, R. T., Allukian, M., Campbell, B. T., Commander, S. J., DeFazio, J. R., Dukleska, K., Echols, J. C., Esparaz, J. R., Gerall, C., Griggs, C. L., … Hanna, D. N. (2024). Postoperative Antibiotics, Outcomes, and Resource Use in Children With Gangrenous Appendicitis. In JAMA Surgery. American Medical Association (AMA). https://doi.org/10.1001/jamasurg.2023.7754