| Complicated appendicitis: is there a minimum intravenous antibiotic requirement? A prospective randomized trial. | |
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MedLine Citation:
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PMID: 10993623 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The proper duration of postoperative intravenous (IV) antibiotics in patients suffering complicated (perforated or gangrenous) appendicitis is debatable. Some advocate a set minimum number of IV antibiotic days whereas others discontinue IV antibiotics depending on the patient's clinical course regardless of the length of therapy. Our objective was to determine whether there are differences in morbidity and resource utilization between the two treatment methodologies. Ninety-four patients with intraoperative findings of complicated appendicitis were included. In all patients IV antibiotics were discontinued on the basis of clinical factors. However, Group 1 patients were given a minimum 5-day IV antibiotic course whereas Group 2 patients had no minimum IV antibiotic requirement. Group 1 patients received more IV antibiotics than Group 2 patients did (5.9 vs 4.3 days; P = 0.014). Infectious complications were not statistically different between the two groups (13.0% in Group 1 and 12.5% in Group 2). Average hospital stay was also not statistically different between the two groups. The data suggest that a protocol with no minimum IV antibiotic requirement in patients with complicated appendicitis does not increase morbidity. Furthermore, the protocol arm with no minimum IV antibiotic requirement led to less IV antibiotic use but did not significantly decrease hospital stay. |
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Authors:
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E Taylor; V Dev; D Shah; J Festekjian; F Gaw |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American surgeon Volume: 66 ISSN: 0003-1348 ISO Abbreviation: Am Surg Publication Date: 2000 Sep |
Date Detail:
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Created Date: 2000-10-11 Completed Date: 2000-10-11 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370522 Medline TA: Am Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 887-90 Citation Subset: IM |
Affiliation:
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Department of Surgery, Kern Medical Center, Bakersfield, California 93305, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Oral Adult Ampicillin / administration & dosage, therapeutic use Anti-Bacterial Agents / administration & dosage, therapeutic use Antibiotic Prophylaxis* Appendicitis / drug therapy, surgery* Case-Control Studies Cephalexin / administration & dosage, therapeutic use Cephalosporins / administration & dosage, therapeutic use Drug Therapy, Combination / administration & dosage, therapeutic use* Female Follow-Up Studies Gangrene / drug therapy, surgery Humans Infusions, Intravenous Intestinal Perforation / drug therapy, surgery* Length of Stay Male Penicillins / administration & dosage, therapeutic use Postoperative Complications Prospective Studies Sulbactam / administration & dosage, therapeutic use Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents; 0/Cephalosporins; 0/Penicillins; 15686-71-2/Cephalexin; 68373-14-8/Sulbactam; 69-53-4/Ampicillin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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