Department of Pediatric General Surgery, Chongqing University Three Gorges Hospital, Chongqing, People's Republic of China.
Department of Pediatric General Surgery, Children's Hospital of Chongqing Medical University, 136 Zhongshan 2nd Rd., Chongqing, 400014, People's Republic of China.
Updates Surg. 2022 Jun;74(3):1027-1033. doi: 10.1007/s13304-021-01207-z. Epub 2022 Jan 8.
No consensus has been reached on the duration of antibiotic prophylaxis for postoperative organ space infection (OSI) following appendectomy. This study investigated the influence of antibiotic administration on postoperative OSIs in children with complex appendicitis. A multicenter, retrospective study was conducted in patients with OSI following complicated appendicitis between 2017 and 2019 at 3 hospitals in China. The qualified patients were dichotomized into a long-duration antibiotic group (> 5.5 days) and a short-duration antibiotic group (< 5.5 days) based on the median duration (5.5 days) of antibiotic administration. Potential biases in baseline characteristics were managed using propensity score matching for the two groups. Primary and secondary outcomes were compared between the two groups. Propensity-matched analysis of the entire cohort revealed no significant effects in terms of the time to OSI resolution (p = 0.16) or recurrence (p = 0.22) for the short-duration and long-duration antibiotic groups. A slightly lower complication rate, including the incidence of abdominal distention (p = 0.093) and antibiotic-associated diarrhea (p = 0.024), was noted in patients with short-duration antibiotic administration. Furthermore, no significant difference in readmission requirements (p = 0.14) or hospitalization duration (p = 0.102) was found between the two groups. For OSI following complicated appendicitis, long-term antibiotic administration did not provide a significant benefit.
对于阑尾炎术后器官间隙感染(OSI)的抗生素预防持续时间,目前尚未达成共识。本研究旨在探讨抗生素给药对复杂性阑尾炎患儿术后 OSI 的影响。这是一项多中心、回顾性研究,纳入了 2017 年至 2019 年期间中国 3 家医院的复杂阑尾炎术后发生 OSI 的患者。合格患者根据抗生素使用中位数(5.5 天)分为长疗程抗生素组(>5.5 天)和短疗程抗生素组(<5.5 天)。采用倾向评分匹配法对两组患者的基线特征进行潜在偏倚管理。比较两组患者的主要和次要结局。对全队列进行倾向评分匹配分析显示,短疗程和长疗程抗生素组在 OSI 缓解时间(p=0.16)或复发时间(p=0.22)方面均无显著差异。短疗程抗生素组的并发症发生率稍低,包括腹胀(p=0.093)和抗生素相关性腹泻(p=0.024)的发生率。此外,两组患者的再入院需求(p=0.14)或住院时间(p=0.102)也无显著差异。对于复杂阑尾炎术后 OSI,长期抗生素治疗并不能带来显著获益。