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Antibiotic using in appendicitis

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https://www.readbyqxmd.com/read/28699771/comparative-effectiveness-of-surgery-versus-antibiotics-in-acute-appendicitis-a-systematic-review
#1
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 12, 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
#2
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
#3
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
#4
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
#5
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
#6
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...
June 9, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28574593/early-versus-delayed-appendicectomy-for-appendiceal-phlegmon-or-abscess
#7
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
#8
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
#9
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...
May 11, 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
#10
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
#11
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
https://www.readbyqxmd.com/read/28468685/a-neglected-risk-for-sparganosis-eating-live-tadpoles-in-central-china
#12
Jing Cui, Ye Wang, Xi Zhang, Xi-Meng Lin, Hong-Wei Zhang, Zhong-Quan Wang, Jia-Xu Chen
A 29-year-old farmer from central China was sent into the Emergency Department of the Affiliated Hospital of Zhengzhou University. He had a 15-day history of persistent high fever, abdominal distention and pain. The patient was clinically diagnosed as appendicitis and peritonitis, and treated with antibiotics in a local hospital, did not improve. On exploratory laparotomy, the appendicular perforation and peritonitis were seen; appendicectomy were performed, and antibiotics were given. However, high fever and abdominal pain still persisted; intestinal adhesion and obstruction, ascites appeared...
May 4, 2017: Infectious Diseases of Poverty
https://www.readbyqxmd.com/read/28423177/comparison-of-appendectomy-outcomes-between-senior-general-surgeons-and-general-surgery-residents
#13
Baha Siam, Abbas Al-Kurd, Natalia Simanovsky, Haitham Awesat, Yahav Cohn, Brigitte Helou, Ahmed Eid, Haggi Mazeh
Importance: In some centers, the presence of a senior general surgeon (SGS) is obligatory in every procedure, including appendectomy, while in others it is not. There is a relative paucity in the literature of reports comparing the outcomes of appendectomies performed by unsupervised general surgery residents (GSRs) with those performed in the presence of an SGS. Objective: To compare the outcomes of appendectomies performed by SGSs with those performed by GSRs...
July 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28346589/comparison-of-antibiotic-therapy-and-appendectomy-for-acute-uncomplicated-appendicitis-in-children-a-meta-analysis
#14
COMPARATIVE STUDY
Libin Huang, Yuan Yin, Lie Yang, Cun Wang, Yuan Li, Zongguang Zhou
Importance: Antibiotic therapy for acute uncomplicated appendicitis is effective in adult patients, but its application in pediatric patients remains controversial. Objective: To compare the safety and efficacy of antibiotic treatment vs appendectomy as the primary therapy for acute uncomplicated appendicitis in pediatric patients. Data Sources: The PubMed, MEDLINE, EMBASE, and Cochrane Library databases and the Cochrane Controlled Trials Register for randomized clinical trials were searched through April 17, 2016...
May 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28338596/operation-versus-antibiotics-the-appendicitis-conundrum-continues-a-meta-analysis
#15
Joseph V Sakran, Konstantinos S Mylonas, Alexandros Gryparis, Stanislaw P Stawicki, Christopher J Burns, Maher M Matar, Konstantinos P Economopoulos
BACKGROUND: Acute appendicitis continues to constitute a diagnostic and therapeutic challenge. The aim of this study was to synthesize evidence from randomized controlled trials (RCTs) comparing nonoperative versus surgical management of uncomplicated acute appendicitis in adult patients. METHODS: A systematic literature search of the PubMed, Cochrane, and Scopus databases was performed with respect to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) statement (end-of-search date: January 29, 2017)...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28284517/antibiotics-first-strategy-for-uncomplicated-acute-appendicitis-in-adults-is-associated-with-increased-rates-of-peritonitis-at-surgery-a-systematic-review-with-meta-analysis-of-randomized-controlled-trials-comparing-appendectomy-and-non-operative-management
#16
REVIEW
Mauro Podda, Nicola Cillara, Salomone Di Saverio, Antonio Lai, Francesco Feroci, Gianluigi Luridiana, Ferdinando Agresta, Nereo Vettoretto
BACKGROUND: Acute appendicitis is the most common surgical diagnosis in young patients, with lifetime prevalence of about 7%. Debate remains on whether uncomplicated AA should be operated or not. Aim of this meta-analysis of randomized controlled trials was to assess current evidence on antibiotic treatment for uncomplicated AA compared to standard surgical treatment. METHODS: Systematic literature search was performed using PubMed, EMBASE, Medline, Google Scholar and Cochrane Central Register of Controlled Trials databases for randomized controlled trials comparing antibiotic therapy (AT) and surgical therapy-appendectomy (ST) for uncomplicated AA...
March 8, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28248876/obturator-externus-abscess-in-a-9-year-old-child-a-case-report-and-literature-review
#17
Charlotte de Bodman, Dimitri Ceroni, Justine Dufour, Pierre-Alex Crisinel, Aline Bregou-Bourgeois, Pierre-Yves Zambelli
RATIONALE: Obturator pyomyositis is a rare condition in children. Diagnosis is often delayed because of its rarity, and the vagaries of its presentation cause it to be easily be missed. Physicians should therefore familiarize themselves with this condition and consider it as a possible differential diagnosis in patients presenting with an acutely painful hip. Inflammatory syndrome is also frequent among sufferers and the MRI is a very sensitive diagnostic tool for obturator pyomyositis...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28210834/conservative-treatment-in-uncomplicated-acute-appendicitis-reassessment-of-practice-safety
#18
Zvi Steiner, Genady Buklan, Rodica Stackievicz, Michael Gutermacher, Ita Litmanovitz, Guy Golani, Shmuel Arnon
The success rate of conservative treatment for children with uncomplicated appendicitis was prospectively evaluated among 197 children. All who received intravenous antibiotics for 3-5 days, and if symptoms resolved, were discharged home on oral antibiotics for 5 days. Failure rate, symptoms, laboratory signs, and sonographic findings were evaluated for prognostic markers of treatment failure. Children were followed for 18 months. The success rate of conservative treatment was 87%, with shorter hospital stays compared to children who eventually needed surgery (72 [60-84] vs...
April 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28174759/-infectious-supercarelessness-in-discussing-antibiotic-resistant-bacteria
#19
Neil S Greenspan
Many bacterial pathogens are exhibiting resistance to increasing numbers of antibiotics making it much more challenging to treat the infections caused by these microbes. In many reports in the media and perhaps even in discussions among physicians and biomedical scientists, these bacteria are frequently referred to as "bugs" with the prefix "super" appended. This terminology has a high potential to elicit unjustified inferences and fails to highlight the broader evolutionary context. Understanding the full range of biological and evolutionary factors that influence the spread and outcomes of infections is critical to formulating effective individual therapies and public health interventions...
October 2016: Pathogens & Immunity
https://www.readbyqxmd.com/read/28162864/use-of-computed-tomography-to-determine-perforation-in-patients-with-acute-appendicitis
#20
Cameron E Gaskill, Vlad V Simianu, Jonathan Carnell, Daniel S Hippe, Puneet Bhargava, David R Flum, Giana H Davidson
PURPOSE: Urgent appendectomy has long been the standard of care for acute appendicitis. Six randomized trials have demonstrated that antibiotics can safely treat appendicitis, but approximately 1 in 4 of these patients eventually requires appendectomy. Overall treatment success may be limited by complex disease including perforation. Patients׳ success on antibiotic therapy may depend on preoperative identification of complex disease on imaging. However, the effectiveness of computed tomography (CT) in differentiating complex disease including perforated from nonperforated appendicitis remains to be determined...
December 7, 2016: Current Problems in Diagnostic Radiology
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