AAP PapersA complete course of intravenous antibiotics vs a combination of intravenous and oral antibiotics for perforated appendicitis in children: a prospective, randomized trial
Section snippets
Methods
Approval was obtained from the Children's Mercy Hospital Internal Review Board (IRB) (IRB# 07 02-031) before enrolling patients in this study. Patients were subsequently enrolled only after obtaining consent from the patient's legal guardian. The consent forms and consent process were carefully evaluated by the IRB on a continual basis. The study was registered with clinicaltrials.gov at the inception of enrollment (NCT# 00462020).
Results
From March 2007 through October 2008, 102 patients were enrolled in the study. Accrual of patients was terminated after the interim analysis when the primary outcome variable (postoperative abscess rate) was found to be identical between the 2 groups.
Discussion
Despite the large volume of children with perforated appendicitis, there is a paucity of prospective data on which management strategies can be based. As a result, wide variability exists in the postoperative management of these patients. A survey of APSA members in 2003 showed that 63.4% use 4 to 7 days of IV antibiotics, while only 3.2% use 1 to 3 days of IV antibiotics [2]. This still leaves a significant portion of pediatric surgeons who routinely employ at least 8 days of IV antibiotics. A
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