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Antibiotic using in appendicitis

Nicholas Agyepong, Usha Govinden, Alex Owusu-Ofori, Sabiha Yusuf Essack
Background: Multidrug-resistant Gram-negative bacteria have emerged as major clinical and therapeutic dilemma in hospitals in Ghana.To describe the prevalence and profile of infections attributable to multidrug-resistant Gram-negative bacteria among patients at the Komfo Anokye Teaching Hospital in the Ashanti region of Ghana. Methods: Bacterial cultures were randomly selected from the microbiology laboratory from February to August, 2015. Bacterial identification and minimum inhibitory concentrations were conducted using standard microbiological techniques and the Vitek-2 automated system...
2018: Antimicrobial Resistance and Infection Control
Dae Woon Song, Byung Kwan Park, Suk Won Suh, Seung Eun Lee, Jong Won Kim, Joong-Min Park, Hye Ryoun Kim, Mi-Kyung Lee, Yoo Shin Choi, Beom Gyu Kim, Yong Gum Park
PURPOSE: Essential treatment of acute appendicitis is surgical resection with the use of appropriate antibiotics. In order to effectively treat acute appendicitis, it is important to identify the microorganism of acute appendicitis and evaluate the effective antibiotics. METHODS: A total of 694 patients who underwent appendectomy for acute appendicitis and had positive microbial result between 2006 and 2015 were recruited. For microbial assessment, luminal contents of the appendix were swabbed after appendectomy...
February 27, 2018: International Journal of Colorectal Disease
Kareem Osman, Sanket Srinivasa, Jonathan Koea
AIM: Historically, liver abscesses (LA) affected elderly, immunocompromised patients and were characterised by high morbidity and mortality, however there are no data pertaining to a New Zealand population with little information surrounding recent management trends. METHODS: A retrospective review of demographic characteristics, clinical management and microbiological data on patients presenting with liver abscess between 2005-2014 was conducted. RESULTS: Fifty-seven patients [37 males, median age 64 (range 15-87)] presented with LA and most patients were not comorbid...
February 23, 2018: New Zealand Medical Journal
Qingjuan Shang, Qiankun Geng, Xuebing Zhang, Chunbao Guo
The aim of this study was to evaluate the efficacy of combined therapy with metronidazole and broad-spectrum antibiotics for patients with perforated appendicitis who underwent surgical intervention.Broad-spectrum antibiotic therapy is warranted in the treatment of perforated appendicitis. Metronidazole has been used as anaerobic antimicrobial therapy. However, few studies about the use of metronidazole in perforated appendicitis have been reported.The medical records of 249 patients treated with metronidazole combined with broad-spectrum antibiotics following perforated appendicitis surgery were reviewed retrospectively and compared with the medical records of 149 patients treated only with broad-spectrum antibiotics...
November 2017: Medicine (Baltimore)
Alejandra Ugarte-Torres, Mark R Gillrie, Thomas P Griener, Deirdre L Church
Background: Eggerthella lenta is a non-sporulating anaerobic gram-positive bacilli associated with polymicrobial intra-abdominal infections. Recently, E. lenta has been recognized as an important cause of anaerobic blood-stream infections (BSI) associated with high mortality. E. lenta has been reported to have high minimal inhibitory concentrations (MICs) to piperacillin-tazobactam (TZP), a broad-spectrum antibiotic with anaerobic coverage commonly used in multiple centers for empiric treatment of abdominal sepsis...
January 24, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Zvi Steiner, Genady Buklan, Michael Gutermacher, Ita Litmanovitz, Tal Landa, Shmuel Arnon
PURPOSE: Appendectomy versus conservative antibiotic treatment (CAT) for children with acute uncomplicated appendicitis (AUA) remains unresolved, with concerns regarding the practicality of CAT. We analyzed our center's experience with CAT for AUA, using a protocol with strict inclusion, exclusion and treatment criteria. METHODS: Non-randomized, prospective cohort study included all children admitted betwee 2014 and 2016, with clinical and laboratory tests suspicious for AUA...
January 17, 2018: Pediatric Surgery International
Andrés García-Marín, Mercedes Pérez-López, Elena Martínez-Guerrero, Lorena Rodríguez-Cazalla, Antonio Compañ-Rosique
BACKGROUND: Microbiologic studies suggest that complicated (CAA) and uncomplicated (UAA) acute appendicitis are different entities. Routine peritoneal fluid cultures continue to be controversially related to a low positive rate, found mainly in UAA; to isolation of typical micro-organisms with expected susceptibilities; and to a community-acquired intra-abdominal infection. The aim of this study was to describe microbiologic isolates in CAA and UAA and the usefulness of peritoneal fluid cultures to determine the susceptibilities to our antibiotic therapy guidelines...
January 2018: Surgical Infections
Thejasvi Subramanian, Ellen Jerome, Ian Jones, Ingo Jester
AIM OF STUDY: Streptococcus anginosus group (SA) (formerly Streptococcus milleri) are pathogens recognised to have a high risk of postoperative collection in appendicitis, although little data exist specifically in children. We performed a retrospective review of all microbiological data from appendicectomies to assess whether there was an association in children. METHODS: A retrospective case note review of patients admitted to a paediatric tertiary centre coded for appendicitis from January 2015 to October 2016 was completed...
November 12, 2017: Journal of Pediatric Surgery
Yasmine Yousef, Fouad Youssef, Trish Dinh, Kartikey Pandya, Hayden Stagg, Michael Homsy, Robert Baird, Jean-Martin Laberge, Dan Poenaru, Pramod Puligandla, Kenneth Shaw, Sherif Emil
PURPOSE: Despite a wide spectrum of severity, perforated appendicitis in children is typically considered a single entity in outcomes studies. We performed a prospective cohort study to define a risk stratification system that correlates with outcomes and resource utilization. METHODS: A prospective study was conducted of all children operated for perforated appendicitis between May 2015 and December 2016 at a tertiary free-standing university children's hospital...
February 2018: Journal of Pediatric Surgery
Max Knaapen, Johanna H van der Lee, Roel Bakx, Sarah-May L The, Ernst W E van Heurn, Hugo A Heij, Ramon R Gorter
INTRODUCTION: Based on epidemiological, immunological and pathology data, the idea that appendicitis is not necessarily a progressive disease is gaining ground. Two types are distinguished: simple and complicated appendicitis. Non-operative treatment (NOT) of children with simple appendicitis has been investigated in several small studies. So far, it is deemed safe. However, its effectiveness and effect on quality of life (QoL) have yet to be established in an adequately powered randomised trial...
November 15, 2017: BMJ Open
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
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
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
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...
November 2017: Journal of Paediatrics and Child Health
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
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...
November 2017: European Journal of Surgical Oncology
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...
December 2017: American Journal of Surgery
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
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...
December 2017: Archives of Disease in Childhood
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
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