Conservative antibiotic treatment of pediatric acute uncomplicated appendicitis during the COVID-19 pandemic: a prospective comparative cohort study

被引:3
|
作者
Tan, Audrey Poh Poh [1 ]
Yap, Te-Lu [1 ]
Cheong, Yee Ling [1 ]
Rai, Rambha [1 ]
Choo, Candy [1 ]
Ong, Caroline [1 ]
Low, Yee [1 ]
Jacobsen, Anette [1 ]
Loh, Amos [1 ]
Ong, Lin Yin [1 ]
Chen, Yong [1 ]
机构
[1] KK Womens & Childrens Hosp, Dept Pediat Surg, 100 Bukit Timah Rd, Singapore 229899, Singapore
关键词
Appendicitis; Child; Appendectomy; Conservative treatment; Recurrence; NONPERFORATED APPENDICITIS; NONOPERATIVE MANAGEMENT; CHILDREN; DIFFERENTIATION; APPENDECTOMY; THERAPY;
D O I
10.1007/s00383-022-05344-3
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background Our study aimed to compare the clinical outcomes and cost-efficiency of antibiotic management versus laparoscopic appendectomy for acute uncomplicated appendicitis (AUA) in children during the COVID-19 pandemic when resources were limited and transmission risks uncertain. Method In this prospective comparative cohort study, we analyzed the data of 139 children diagnosed with AUA meeting the following inclusion criteria: 5-18 years of age, symptoms duration of <= 48 h, appendix diameter <= 11 mm and no appendicolith. Treatment outcomes between non-operative management group (78/139) and upfront laparoscopic appendectomy group (61/139) were compared. Antibiotic regimes were intravenous ceftriaxone/metronidazole or amoxicillin/clavulanic acid for 48 h, followed by oral antibiotics to complete total 10-days course. Results 8/78 (10.3%) children had early failure (within 48 h) requiring appendectomy. 17/70 (24.3%) patients experienced late recurrence within mean follow-up time of 16.2 +/- 4.7 months. There were no statistical differences in peri-operative complications, negative appendicectomy rate, and incidence of perforation and hospitalization duration between antibiotic and surgical treatment groups. Cost per patient in upfront surgical group was significantly higher ($6208.5 +/- 5284.0) than antibiotic group ($3588.6 +/- 3829.8; p = 0.001). Conclusion Despite 24.3% risk of recurrence of appendicitis in 16.2 +/- 4.7 months, antibiotic therapy for AUA appears to be a safe and cost-effective alternative to upfront appendectomy.
引用
收藏
页数:8
相关论文
共 50 条
  • [41] Suspected and Confirmed Acute Appendicitis During the COVID-19 Pandemic: First and Second Quarantines-a Prospective Study
    Petrauskas, Vidas
    Poskus, Eligijus
    Luksaite-Lukste, Raminta
    Kryzauskas, Marius
    Petrulionis, Marius
    Strupas, Kestutis
    Poskus, Tomas
    FRONTIERS IN SURGERY, 2022, 9
  • [42] Variations in clinical course and surgical outcomes of acute appendicitis during COVID-19 Pandemic: a multicenter cohort study
    Carlos Eduardo Rey Chaves
    Felipe Girón
    Ricardo E. Núñez-Rocha
    Elkin Benítez
    Saralia Ruiz
    Lina Rodríguez
    Daniela Ayala
    Carlos José Villamil
    Valentina Galvis
    Marco Vanegas
    Mónica Gómez
    Ricardo Nassar
    Juan David Hernández
    Danny Conde
    María Gómez Zuleta
    BMC Surgery, 23
  • [43] Variations in clinical course and surgical outcomes of acute appendicitis during COVID-19 Pandemic: a multicenter cohort study
    Chaves, Carlos Eduardo Rey
    Giron, Felipe
    Nunez-Rocha, Ricardo E.
    Benitez, Elkin
    Ruiz, Saralia
    Rodriguez, Lina
    Ayala, Daniela
    Villamil, Carlos Jose
    Galvis, Valentina
    Vanegas, Marco
    Gomez, Monica
    Nassar, Ricardo
    Hernandez, Juan David
    Conde, Danny
    Zuleta, Maria Gomez
    BMC SURGERY, 2023, 23 (01)
  • [44] Comparison of Pediatric Acute Appendicitis Before and During the COVID-19 Pandemic in New York City
    Mallikarjuna, Priya
    Goswami, Saikat
    Ma, Sandy
    Baik-Han, Won
    Cervellione, Kelly L.
    Gulati, Gagan
    Lew, Lily Q.
    WESTERN JOURNAL OF EMERGENCY MEDICINE, 2023, 24 (05) : 956 - 961
  • [45] Navigating appendicitis care during the Covid-19 pandemic: a retrospective cohort study in China
    Fu, Guang
    Xu, Zishun
    Zhang, Shao
    BMC SURGERY, 2024, 24 (01)
  • [46] Pediatric Perforated Appendicitis Rate Increased During the Covid-19 Pandemic
    Sacks, Marla A.
    Goodman, Laura F.
    Mendez, Yomara S.
    Khan, Faraz A.
    Moores, Donald C.
    Radulescu, Andrei
    JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2021, 233 (05) : E151 - E151
  • [47] Response to "Incidence and severity of pediatric appendicitis during the COVID-19 pandemic"
    del Giorgio, Francesca
    Gravel, Jocelyn
    Piche, Nelson
    Drouin, Olivier
    WORLD JOURNAL OF PEDIATRICS, 2023, 19 (07) : 713 - 713
  • [48] Pediatric Complicated Appendicitis During the COVID-19 Pandemic: A National Perspective
    Hafezi, Niloufar
    Pecoraro, Anthony
    Landman, Matthew P.
    Colgate, Cameron
    Rescorla, Frederick J.
    JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2021, 233 (05) : S181 - S181
  • [49] A Prospective Analysis of Imaging Modalities in Appendicitis during the COVID-19 Pandemic
    Saravanan, Nivetha
    Javanmard-Emamghissi, Hannah
    Lund, Jonathan
    Tierney, Gillian
    BRITISH JOURNAL OF SURGERY, 2021, 108 : 92 - 92
  • [50] The Results of Treatment of Acute Appendicitis During COVID-19 Pandemic in A District General Hospital
    Urbonas, T.
    Centea, D.
    Wild, T.
    Thomas, P.
    BRITISH JOURNAL OF SURGERY, 2021, 108