The Impact of Redosing Antibiotics for Pediatric Patients Undergoing Appendectomy for Complicated Appendicitis

Am Surg. 2024 Apr 18:31348241248815. doi: 10.1177/00031348241248815. Online ahead of print.

Abstract

Currently, there is no universally accepted, standardized protocol for pre-operative antibiotic administration in the setting of appendectomy for complicated appendicitis among pediatric patients. Strategies to mitigate surgical site infections (SSIs) must be balanced with optimal antibiotic use and exposure. We conducted a retrospective chart review to compare outcomes between patients treated pre-operatively with a single pre-operative dose of antibiotics with those who received additional antibiotics prior to laparoscopic appendectomy for complicated appendicitis between 2020 and 2022. Of 124 pediatric patients, 18% received an additional dose of pre-operative antibiotics after initial treatment dose. Surgical site infection rates between the two groups were not statistically significant (P-value = .352), thereby suggesting that redosing antibiotics closer to the time of incision may not impact SSI rates. Additional studies are necessary to make clinical recommendations.

Keywords: general surgery; pediatric surgery; surgical infection; wound healing.