Comparison of Monotherapy with Piperacillin/Tazobactam Versus Multidrug Therapy for Treatment of Perforated Appendix in Children Monotherapy vs. Multidrug Therapy for Perforated Appendix in Children
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Abstract
Background: Appendicitis is the most common surgical emergency in pediatric patients, with perforated appendicitis posing significant risks due to postoperative complications. The optimal antibiotic regimen to manage these risks remains debated.
Objective: To compare the efficacy of piperacillin/tazobactam monotherapy versus ceftriaxone and metronidazole multi-drug therapy in children undergoing open appendectomy for perforated appendicitis.
Methods: This randomized study included 74 pediatric patients (aged 4-13 years) diagnosed with perforated appendicitis at the Pediatric Surgery Department, Mayo Hospital, between December 2023 and June 2024. Patients were randomized into two groups: Group A received piperacillin/tazobactam monotherapy, and Group B received ceftriaxone and metronidazole. The primary outcomes were surgical site infections (SSI), intra-abdominal collections, and hospital stay. Data were analyzed using SPSS version 25, with significance set at p≤0.05.
Results: Intra-abdominal collection occurred in 2 patients (5.4%) in Group A and 3 patients (8.1%) in Group B (p=0.643). SSI rates were 13.5% in Group A and 10.8% in Group B (p=0.722). The mean hospital stay was significantly shorter in Group B (7.16±0.727 days) compared to Group A (7.92±0.829 days, p<0.05).
Conclusion: Monotherapy with piperacillin/tazobactam demonstrated comparable effectiveness to multi-drug therapy, but multi-drug therapy resulted in a shorter hospital stay.
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