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Antibiotic using in appendicitis

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https://www.readbyqxmd.com/read/29075315/the-current-management-of-acute-uncomplicated-appendicitis-should-there-be-a-change-in-paradigm-a-systematic-review-of-the-literatures-and-analysis-of-treatment-performance
#1
REVIEW
Samuel Ho Ting Poon, Jennifer Wah Yan Lee, Ka Man Ng, Gloria Wing Yan Chiu, Brian Yung Kong Wong, Chi Chung Foo, Wai Lun Law
INTRODUCTION: Appendectomy has long been the mainstay of intervention for acute appendicitis, aiming at preventing perforation, peritonitis, abscess formation and recurrence. With better understanding of the disease process, non-operative management (NOM) with antibiotics alone has been proved a feasible treatment for uncomplicated appendicitis. This article aimed at systematically reviewing the available literatures and discussing the question whether NOM should replace appendectomy as the standard first-line treatment for uncomplicated appendicitis...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/29064344/low-infection-related-re-admission-rates-in-a-retrospective-of-4725-children-with-appendicitis-using-a-clinical-pathway-in-a-tertiary-care-pediatric-center
#2
Nikolas E Marino, Kate Davenport, Mary Hilfiker, Simone Langness, Timothy Fairbanks, Erin Stucky Fisher, Robert Newbury, Allyson Andrews, Alan Wells, Juan D Chaparro, John S Bradley
BACKGROUND: Standardization of antibiotic management of appendicitis in tertiary care pediatric centers has been associated with improved outcomes. Rady Children's Hospital-San Diego implemented an appendicitis clinical pathway in 2005. We evaluated infection-related re-admission risk factors since 2010, when an electronic medical record was established, with the aim to optimize the clinical pathway. METHODS: Between January 2010 and August 2015, 4725 children with a diagnosis of appendicitis were evaluated for demographic data, pathology diagnoses, culture results, and inpatient and oral step-down antibiotic therapy regimens...
October 24, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29058569/surgical-site-infections-after-appendectomy-performed-in-low-and-middle-human-development-index-countries-a-systematic-review
#3
Deshka Foster, Will Kethman, Lawrence Z Cai, Thomas G Weiser, Joseph D Forrester
BACKGROUND: Acute appendicitis is a common surgical emergency worldwide. Early intervention is associated with better outcomes. In low and middle Human Development-Index Countries (LMHDICs), late presentation and poor access to healthcare facilities can contribute to greater illness severity and higher complication rates, such as post-operative surgical site infections (SSIs). The current rate of SSIs post-appendectomy in low- and middle-index settings has yet to be described. METHODS: We performed a systemic review of the literature describing the incidence and management of SSIs after appendectomy in LMHDICs...
October 23, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29044790/acute-appendicitis
#4
REVIEW
Mark D Stringer
Acute appendicitis is the most common reason for abdominal surgery in children. Luminal obstruction of the appendix progresses to suppurative inflammation and perforation, which causes generalised peritonitis or an appendix mass/abscess. Classical features include periumbilical pain that migrates to the right iliac fossa, anorexia, fever, and tenderness and guarding in the right iliac fossa. Atypical presentations are particularly common in preschool children. A clinical diagnosis is possible in most cases, after a period of active observation if necessary; inflammatory markers and an ultrasound scan are useful investigations when the diagnosis is uncertain...
October 17, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29027898/surgery-versus-antibiotics-for-uncomplicated-appendicitis-which-would-a-medical-student-want
#5
Alison R Althans, Pierre Tamer, Justin T Brady, Emily Steinhagen, Vanessa P Ho
BACKGROUND: Recent data suggest that treatment of acute, uncomplicated appendicitis (AUA) with antibiotics is as effective as surgery. A 2015 study indicated that more than 50% of patients would choose antibiotic therapy. Medical students represent a unique population of potential patients with greater medical knowledge than the general public and possibly less bias than practicing physicians. Therefore, we aimed to evaluate what the MEDICAL STUDENT'S treatment choice for AUA would be and what factors influence these decisions...
October 13, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28942236/increased-incidence-of-bowel-cancer-after-non-surgical-treatment-of-appendicitis
#6
Malin Enblad, Helgi Birgisson, Anders Ekbom, Fredrik Sandin, Wilhelm Graf
BACKGROUND: There is an ongoing debate on the use of antibiotics instead of appendectomy for treating appendicitis but diagnostic difficulties and longstanding inflammation might lead to increased incidence of bowel cancer in these patients. The aim of this population-based study was to investigate the incidence of bowel cancer after non-surgical treatment of appendicitis. PATIENTS AND METHODS: Patients diagnosed with appendicitis but lacking the surgical procedure code for appendix removal were retrieved from the Swedish National Inpatient Register 1987-2013...
September 7, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28941724/operative-versus-non-operative-management-in-the-care-of-patients-with-complicated-appendicitis
#7
Thomas S Helling, Douglas F Soltys, Samantha Seals
BACKGROUND: The approach to complicated appendicitis is unclear. We have sought to determine factors which may persuade surgeons to non-operative management and whether such treatment affects outcome. METHODS: All adult patients admitted over a five-year period 2009-2014 with a diagnosis of appendicitis were reviewed. Patients were grouped into uncomplicated and complicated presentations and stratified by age, gender, ethnicity, socio-economic status, and time to presentation...
September 18, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28892998/role-of-multi-detector-ct-mdct-in-evaluation-of-bowel-diseases
#8
Mohamad Tufail Sheikh, Mohd Tafazul Sheikh, Masrat Jan, Hayat A Khan, Guru P Vashisht, Mohd L Wani
INTRODUCTION: Multi-Detector Computed Tomography (MDCT) has revealed excellent results in various systems of the body. Its role in abdominal imaging for solid viscera has been proved beyond doubt. It is an emerging non invasive tool for evaluation of bowel diseases. AIM: To see the efficacy of MDCT in evaluation of various bowel diseases. MATERIALS AND METHODS: The study was carried out in the Department of Radiodiagnosis and Imaging, Batra Hospital and Medical Research Centre, Delhi, India...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28818844/conservative-treatment-versus-surgery-for-uncomplicated-appendicitis-in-children-a-systematic-review-and-meta-analysis
#9
Ulf Kessler, Selim Mosbahi, Benedict Walker, Eva M Hau, Michael Cotton, Barbara Peiry, Steffen Berger, Bernhard Egger
OBJECTIVES: To compare conservative treatment with index admission appendicectomy in children with acute uncomplicated appendicitis. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Medline, Embase and the Cochrane Library (CENTRAL) from 1950 to 18 February 2017. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies that assessed both appendicectomy and non-operative management of acute uncomplicated appendicitis in children of less than 18 years of age...
August 17, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28699771/comparative-effectiveness-of-surgery-versus-antibiotics-in-acute-appendicitis-a-systematic-review
#10
Stephanie D Talutis, Frederick Thurston Drake
AIM: To review outcomes of surgical and antibiotic management of acute appendicitis. METHODS: 11 prospective studies comparing surgical versus antibiotic management of acute appendicitis over a 21-year period were reviewed. RESULTS: Antibiotic management is successful in most cases of uncomplicated acute appendicitis. The need for crossover in management and recurrent appendicitis were low among all studies. For those patients who ultimately required surgery, no increased complications were observed...
July 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/28654543/extended-versus-narrow-spectrum-antibiotics-in-the-management-of-uncomplicated-appendicitis-in-children-a-propensity-matched-comparative-effectiveness-study
#11
Danielle B Cameron, Patrice Melvin, Dionne A Graham, Charity C Glass, Stephanie K Serres, Matthew P Kronman, Jacqueline M Saito, Shawn J Rangel
OBJECTIVE: The aim of this study was to compare the effectiveness of extended versus narrow spectrum antibiotics in preventing surgical site infections (SSIs) and hospital revisits in children with uncomplicated appendicitis. SUMMARY OF BACKGROUND DATA: There is a paucity of high-quality evidence in the pediatric literature comparing the effectiveness of extended versus narrow-spectrum antibiotics in the prevention of SSIs associated with uncomplicated appendicitis...
June 26, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28629607/post-operative-management-of-perforated-appendicitis-can-clinical-pathways-improve-outcomes
#12
Robert R Gerard, Barrett A Kielhorn, Brent Petersen, Andrew J Mullard, Laurence E McCahill
BACKGROUND: We sought to decrease organ space infection (OSI) following appendectomy for perforated acute appendicitis (PAA) by minimizing variation in clinical management. OBJECTIVE: A postoperative treatment pathway was developed and four recommendations were implemented: 1) clear documentation of post-operative diagnosis, 2) patients with unknown perforation status to be treated as perforated pending definitive diagnosis, 3) antibiotic therapy to be continued post operatively for 4-7 days after SIRS resolution, and 4) judicious use of abdominal computed tomography (CT) scanning prior to post-operative day 5...
June 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28614043/antibiotics-vs-appendectomy-for-acute-uncomplicated-appendicitis-in-adults-review-of-the-evidence-and-future-directions
#13
REVIEW
Jared M Huston, Lillian S Kao, Phillip K Chang, James M Sanders, Sara Buckman, Charles A Adams, Christine S Cocanour, Sarah E Parli, Julia Grabowski, Jose Diaz, Jeffrey M Tessier, Therese M Duane
BACKGROUND: Acute appendicitis is the most common abdominal surgical emergency in the United States, with a lifetime risk of 7%-8%. The treatment paradigm for complicated appendicitis has evolved over the past decade, and many cases now are managed by broad-spectrum antibiotics. We determined the role of non-operative and operative management in adult patients with uncomplicated appendicitis. METHODS: Several meta-analyses have attempted to clarify the debate. Arguably the most influential is the Appendicitis Acuta (APPAC) Trial...
July 2017: Surgical Infections
https://www.readbyqxmd.com/read/28607552/procalcitonin-guided-antibiotics-after-surgery-for-peritonitis-a-randomized-controlled-study
#14
Juliette C Slieker, Steve Aellen, Philippe Eggimann, Valentine Guarnero, Markus Schäfer, Nicolas Demartines
BACKGROUND: Serum procalcitonin (PCT) is a useful biomarker to tailor the duration of antibiotics in respiratory infections. The objective of this study was to determine whether PCT levels could tailor postoperative antibiotic therapy in patients operated for peritonitis. METHOD: Patients with peritonitis were randomized postoperatively. The control group received antibiotics for a defined duration according to institutional guidelines. In the study group, antibiotics were stopped based on serum PCT levels...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28600695/enteral-antibiotics-are-non-inferior-to-intravenous-antibiotics-after-complicated-appendicitis-in-adults-a-retrospective-multicentre-non-inferiority-study
#15
Jakob Kleif, Louise Rasmussen, Siv Fonnes, Pernille Tibæk, Alaa Daoud, Helle Lund, Ismail Gögenur
BACKGROUND: Prolonging post-operative antibiotic treatment beyond 3 days does not seem to reduce the incidence of post-operative abscess formation or wound infection after surgery for complicated appendicitis. The route of administration seems to be based on an empirical basis. Using enteral antibiotics could reduce length of stay and reduce overall costs. We aimed to examine whether treatment with enteral antibiotics during the first three post-operative days is non-inferior to intravenous antibiotics regarding intra-abdominal abscess formation or wound infection after surgery for complicated appendicitis...
November 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28574593/early-versus-delayed-appendicectomy-for-appendiceal-phlegmon-or-abscess
#16
REVIEW
Yao Cheng, Xianze Xiong, Jiong Lu, Sijia Wu, Rongxing Zhou, Nansheng Cheng
BACKGROUND: Appendiceal phlegmon and abscess account for 2% to 10% of acute appendicitis. People with appendiceal phlegmon or abscess usually need an appendicectomy to relieve their symptoms and avoid complications. The timing of appendicectomy for appendiceal phlegmon or abscess is controversial. OBJECTIVES: To assess the effects of early versus delayed appendicectomy for appendiceal phlegmon or abscess, in terms of overall morbidity and mortality. SEARCH METHODS: We searched the Cochrane Library (CENTRAL; 2016, Issue 7), MEDLINE Ovid (1950 to 23 August 2016), Embase Ovid (1974 to 23 August 2016), Science Citation Index Expanded (1900 to 23 August 2016), and the Chinese Biomedical Literature Database (CBM) (1978 to 23 August 2016)...
June 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28554816/a-pre-operative-clinical-scoring-system-to-distinguish-perforation-risk-with-pediatric-appendicitis
#17
William Bonadio, Syeda Shahid, Lior Vardi, Carly Buckingham, Allison Kornblatt, Chloe Free, Peter Homel
IMPORTANCE: Appendicitis is a common, potentially serious pediatric disease. An important factor in determining management strategy [whether/when to perform appendectomy, duration of antibiotic therapy/hospitalization, etc.] and predicting outcome is distinguishing whether perforation is present. OBJECTIVE: The objective was to determine efficacy of commonly assessed pre-operative variables in stratifying perforation risk in children with appendicitis. DESIGN: A retrospective analysis of consecutive cases was performed...
May 22, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28535960/nonoperative-management-in-children-with-early-acute-appendicitis-a-systematic-review
#18
REVIEW
Jane Xu, Susan Adams, Yingrui Cyril Liu, Jonathan Karpelowsky
PURPOSE: Appendectomy has remained the gold standard treatment of acute appendicitis for more than 100years. Nonoperative management (NOM) has been shown to be a valid treatment alternative for acute uncomplicated appendicitis in adults. A systematic review of available evidence comparing operative management (OM) and NOM in children with acute uncomplicated appendicitis was performed. METHODS: Systematic searches of MedLine, Embase, and a clinical trial register (https://clinicaltrials...
September 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28494476/effect-of-the-shorter-stays-in-emergency-departments-time-target-policy-on-key-indicators-of-quality-of-care
#19
MULTICENTER STUDY
Peter Jones, James Le Fevre, Alana Harper, Susan Wells, Joanna Stewart, Elana Curtis, Papaarangi Reid, Shanthi Ameratunga
AIM: To determine whether implementation of a national health target called Shorter Stays in Emergency Departments impacted on clinical markers of quality of care. METHOD: A retrospective pre- and post-intervention study from 2006 to 2012 examined quality of care metrics for five different indicators at different sites in relation to the implementation of the target using a general linear model for times to treatment. Explanatory variables included period (pre- or post-target), ethnicity, age, deprivation and severity of condition...
May 12, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28477257/control-of-emerging-contaminants-by-the-combination-of-electrochemical-processes-and-membrane-bioreactors
#20
Benny Marie B Ensano, Laura Borea, Vincenzo Naddeo, Mark Daniel G de Luna, Vincenzo Belgiorno
This study investigates the removal of selected pharmaceuticals, as recalcitrant organic compounds, from synthetic wastewater using an electro-membrane bioreactor (eMBR). Diclofenac (DCF), carbamazepine (CBZ), and amoxicillin (AMX) were selected as representative drugs from three different therapeutic groups such as anti-inflammatory, anti-epileptic, and antibiotic, respectively. An environmentally relevant concentration (10 μg/L) of each compound was spiked into the synthetic wastewater, and then, the impact of appending electric field on the control of membrane fouling and the removal of conventional contaminants and pharmaceutical micropollutants were assessed...
May 5, 2017: Environmental Science and Pollution Research International
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