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Antibiotics appendicitis

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https://www.readbyqxmd.com/read/28092251/-acute-appendicitis-surgical-and-non-surgical-treatment
#1
Luis Manuel Souza-Gallardo, José Luis Martínez-Ordaz
Appendicitis represents a common disease for the surgeon with a relative risk between 7-8%. It was thought that if more time passed between diagnosis and treatment, the risk for complications, such as perforation or abscess formation, was higher; nevertheless; the evolution is variable, making necessary the development of different strategies such as antibiotic use only, interval surgery or endoscopic treatment. The purpose of this study is to make a revision in the management of appendicitis comparing conservative and surgical treatment...
January 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28063718/second-date-appendectomy-operating-for-failure-of-nonoperative-treatment-in-perforated-appendicitis
#2
Marco Lotti
BACKGROUND: Nonoperative treatment of acute appendicitis is embraced by many surgical teams, driven by low to moderate quality randomized studies that support noninferiority of antibiotics versus appendectomy for treatment of acute uncomplicated appendicitis. Several flaws of these studies have emerged, especially in the recruitment strategy and in the diagnostic criteria that were used. The growing confidence given to antibiotics, together with the lack of reliable criteria to distinguish between uncomplicated and perforated appendicitis, exposes patients with perforated appendicitis to the likelihood to be treated with antibiotics instead of surgery...
January 2, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28049113/update-on-pediatric-overuse
#3
Eric R Coon, Paul C Young, Ricardo A Quinonez, Daniel J Morgan, Sanket S Dhruva, Alan R Schroeder
As concerns over health care-related harms and costs continue to mount, efforts to identify and combat medical overuse are needed. Although much of the recent attention has focused on health care for adults, children are also harmed by overuse. Using a structured PubMed search and manual tables of contents review, we identified important articles on pediatric overuse published in 2015. These articles were evaluated according to the quality of the methods, the magnitude of clinical effect, and the number of patients potentially affected and were categorized into overdiagnosis, overtreatment, and overutilization...
January 3, 2017: Pediatrics
https://www.readbyqxmd.com/read/28039865/sonographic-differentiation-of-complicated-from-uncomplicated-appendicitis-implications-for-antibiotics-first-therapy
#4
Yingding Xu, R Brooke Jeffrey, Stephanie T Chang, Michael A DiMaio, Eric W Olcott
OBJECTIVES: To evaluate sonographic findings as indicators of complicated versus uncomplicated appendicitis in the setting of known appendicitis, a necessary distinction in deciding whether to proceed with antibiotic therapy or with appendectomy. METHODS: With Institutional Review Board approval and Health Insurance Portability and Accountability Act compliance, appendiceal sonograms of 119 patients with histopathologically proven appendicitis were retrospectively blindly reviewed to determine the presence or absence of the normally echogenic submucosal layer, the presence of mural hyperemia, periappendiceal fluid, appendicoliths, and hyperechoic periappendiceal fat and to determine the maximum outside diameter...
December 31, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28003294/acute-uncomplicated-appendicitis-study-rationale-and-protocol-for-a-multicentre-prospective-randomised-controlled-non-inferiority-study-to-evaluate-the-safety-and-effectiveness-of-non-operative-management-in-children-with-acute-uncomplicated-appendicitis
#5
Jane Xu, Yingrui Cyril Liu, Susan Adams, Jonathan Karpelowsky
INTRODUCTION: This article presents an overview of a prospective randomised controlled non-inferiority study designed to evaluate the safety and effectiveness of non-operative management (NOM) with operative management in children with acute uncomplicated appendicitis (AUA). Here, we present the study protocol for this APRES study, a multicentre Australian study. The rationale and details of future analysis, in particular, non-inferiority calculations, cost-effectiveness, feasibility and acceptability of each intervention...
December 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27987280/abdominal-pain-learning-when-not-to-intervene
#6
Niranjan Tachamo, Bidhya Timilsina, Salik Nazir, Saroj Lohani
Epiploic appendagitis (EA) is an uncommon cause of abdominal pain. It is a benign condition but may mimic other serious causes of acute abdomen such as appendicitis, diverticulitis, and gynecological emergency in severe cases. Knowledge of this condition in the differential diagnosis of abdominal pain can save unnecessary hospital admission, antibiotics, and surgery. In this article, we present the case of a 43-year-old female who presented to our hospital with a 2-day history of right lower quadrant abdominal pain and diarrhea...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27974169/antibiotics-first-versus-surgery-for-appendicitis-a%C3%A2-us-pilot-randomized-controlled-trial-allowing-outpatient-antibiotic-management
#7
David A Talan, Darin J Saltzman, William R Mower, Anusha Krishnadasan, Cecilia M Jude, Ricky Amii, Daniel A DeUgarte, James X Wu, Kavitha Pathmarajah, Ashkan Morim, Gregory J Moran
STUDY OBJECTIVE: Randomized trials suggest that nonoperative treatment of uncomplicated appendicitis with antibiotics-first is safe. No trial has evaluated outpatient treatment and no US randomized trial has been conducted, to our knowledge. This pilot study assessed feasibility of a multicenter US study comparing antibiotics-first, including outpatient management, with appendectomy. METHODS: Patients aged 5 years or older with uncomplicated appendicitis at 1 US hospital were randomized to appendectomy or intravenous ertapenem greater than or equal to 48 hours and oral cefdinir and metronidazole...
December 11, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27916376/factors-predictive-of-complicated-appendicitis-in-children
#8
Xuan-Binh D Pham, Veronica F Sullins, Dennis Y Kim, Blake Range, Amy H Kaji, Christian M de Virgilio, Steven L Lee
BACKGROUND: The ability to predict whether a child has complicated appendicitis at initial presentation may influence clinical management. However, whether complicated appendicitis is associated with prehospital or inhospital factors is not clear. We also investigate whether hyponatremia may be a novel prehospital factor associated with complicated appendicitis. MATERIALS AND METHODS: A retrospective review of all pediatric patients (≤12 y) with appendicitis treated with appendectomy from 2000 to 2013 was performed...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27873747/atypical-presentation-of-appendicitis
#9
Oliver Beaumont, Robert Miller, Richard Guy
A woman aged 64 years presented as an emergency with a mass in the right iliac fossa, clinically within the abdominal wall, but an otherwise soft abdomen. Systemically, she was quite well with normal vital signs. Blood tests revealed raised inflammatory markers, and an abdominal CT scan demonstrated a perforated appendix with associated large subcutaneous abscess. This represents a rare presentation of a common condition, demonstrating how appendicitis can still be a challenging problem for the clinician...
November 10, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27871681/postoperative-antibiotic-use-and-the-incidence-of-intra-abdominal-abscess-in-the-setting-of-suppurative-appendicitis-a-retrospective-analysis
#10
Esther Bae, Ahmed Dehal, Vanessa Franz, Michael Joannides, Nicholas Sakis, Joshua Scurlock, Patrick Nguyen, Farabi Hussain
BACKGROUND: Although guidelines exist for postoperative antibiotic use in acute appendicitis that is perforated, gangrenous, or simple/uncomplicated, there are less data about its use in suppurative appendicitis. Here, we targeted this subgroup of patients to determine whether postoperative antibiotic administration affects incidence of intra-abdominal abscess formation. METHODS: We retrospectively examined 1,192 patients who underwent laparoscopic appendectomy for acute appendicitis at Kaiser Permanente Fontana Hospital between August 2010 and August 2013...
December 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27846185/single-incision-laparoscopic-appendectomy-by-surgical-trainees
#11
Sang Gyun Suh, Hee Joo Sohn, Beom Gyu Kim, Joong-Min Park, Yoo-Shin Choi, Yong Keum Park, Seung Eun Lee
BACKGROUND: Single-incision laparoscopic appendectomy (SILA) is one of the most commonly performed single port surgeries in the world. However, there are few publications documenting a young resident's experience. The purpose of this study is to investigate clinical outcomes of SILA performed by a surgical trainee and to evaluate its feasibility and safety compared with conventional three-port laparoscopic appendectomy (TPLA) when performed by a surgical trainee and SILA by surgical staff...
December 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27818877/analysis-of-antibiotics-selection-in-patients-undergoing-appendectomy-in-a-chinese-tertiary-care-hospital
#12
Shengyong Xu, Xuezhong Yu, Yi Li, Donglei Shi, Jingya Huang, Qian Gao, Ting Zhang, Shigong Guo
BACKGROUND: To investigate the status of antibiotics use in acute appendicitis patients who undergo appendectomy in a Chinese tertiary care hospital. METHODS: A retrospective analysis of 93 patients who underwent appendectomy from June 1, 2011 to May 30, 2012 and had recorded use of intravenous antibiotics. We defined simple appendicitis and suppurative appendicitis as mild appendicitis. Gangrenous appendicitis and perforated appendicitis were classified as advanced appendicitis...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27816201/fast-track-pathway-for-perforated-appendicitis
#13
Richard Frazee, Stephen Abernathy, Matthew Davis, Travis Isbell, Justin Regner, Randall Smith
BACKGROUND: Perforated appendicitis is associated with an increased morbidity and length of stay. "Fast track" protocols have demonstrated success in shortening hospitalization without increasing morbidity for a variety of surgical processes. This study evaluates a fast track pathway for perforated appendicitis. METHODS: In 2013, a treatment pathway for perforated appendicitis was adopted by the Acute Care Surgery Service for patients having surgical management of perforated appendicitis...
October 20, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27794239/a-case-report-of-necrotizing-fasciitis-of-the-abdominal-wall-a-rare-life-threatening-complication-of-a-common-disease-process
#14
Anya Romanoff, Jeffrey Freed, Tomas Heimann
INTRODUCTION: Acute appendicitis is one of the most common surgical diseases, but perforated appendicitis resulting in necrotizing fasciitis of the abdominal wall is exceedingly rare. PRESENTATION OF CASE: A 71-year-old male presented to the emergency department with one week of severe right-sided abdominal pain. He was hypothermic, hypotensive, and tachycardic. His abdomen was distended, with a large, tender, erythematous region over the right abdominal wall. Laboratory evaluation revealed leukocytosis, acute kidney injury, and lactic acidosis...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27777701/the-role-of-dna-amplification-and-cultural-growth-in-complicated-acute-appendicitis
#15
Francesca Tocchioni, Chiara Tani, Laura Bartolini, Maria Moriondo, Francesco Nieddu, Patrizia Pecile, Chiara Azzari, Antonio Messineo, Marco Ghionzoli
Bacterial growth of peritoneal fluid specimens obtained during surgical procedures for acute appendicitis may be useful to optimize further antibiotic therapy in complicated cases. DNA amplification represents a fast technique to detect microbial sequences. We aimed to compare the potential of DNA amplification versus traditional bacterial growth culture highlighting advantages and drawbacks in a surgical setting. Peritoneal fluid specimens were collected during surgery from 36 children who underwent appendectomy between May and December 2012...
September 19, 2016: Pediatric Reports
https://www.readbyqxmd.com/read/27775308/-appendicular-actinomycosis-as-a-cause-of-ileocecal-mass-in-children-case-report
#16
M Fernández Castilla, A Salazar Villacorta, A Martín Nalda, J C Ferreres Piñas, A Coma Muñoz, G Guillén Burrieza
INTRODUCTION: Appendicular actinomycosis is a rare disease produced by cecal appendix invasion by Actinomyces gender bacteria after a predisposing cause that disrupts mucosal barrier, such as acute appendicitis. The highest frequency appears in adults; however, there are cases in paediatric age described in literature. The aim of this article is to introduce a case of appendicular actinomycosis in a child with atypical presentation and to review the literature. CLINICAL CASE: 10-year-old boy transferred to our hospital due to intraoperative finding at a different centre of a right flank tumor, without identification of cecal appendix...
July 20, 2015: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/27775294/-fast-track-protocol-for-children-undergoing-appendicectomy
#17
M Fanjul, L Pérez, J Cerdá, M Zornoza, R Rojo, I Simal, M A García-Casillas, C Corona, D Peláez, E Molina, A Parente, S Rivas, J M Angulo, E De Tomás
BACKGROUND: Multiple approaches to the treatment of simple and complicated (gangrenous or perforated) appendicitis in children have been promoted. Our goal is to develop a new protocol for these patients that allows shorter hospital stays without increasing complications rates. METHODS: Prospective collected data of patients undergoing appendicitis treated according to the new protocol for a period of 7 months were reviewed. This protocol consists on antibiotic prophylaxis in all cases continued with triple antibiotic regimen in complicated appendicitis...
October 10, 2015: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/27759621/antibiotics-versus-surgical-therapy-for-uncomplicated-appendicitis-systematic-review-and-meta-analysis-of-controlled-trials-prospero-2015-crd42015016882
#18
Julian C Harnoss, Isabelle Zelienka, Pascal Probst, Kathrin Grummich, Catharina Müller-Lantzsch, Jonathan M Harnoss, Alexis Ulrich, Markus W Büchler, Markus K Diener
OBJECTIVE: The aim was to investigate available evidence regarding effectiveness and safety of surgical versus conservative treatment of acute appendicitis. SUMMARY OF BACKGROUND DATA: There is ongoing debate on the merits of surgical and conservative treatment for acute appendicitis. METHODS: A systematic literature search (Cochrane Library, Medline, Embase) and hand search of retrieved reference lists up to January 2016 was conducted to identify randomized and nonrandomized studies...
October 17, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27756361/therapeutic-effectiveness-of-percutaneous-drainage-and-factors-for-performing-an-interval-appendectomy-in-pediatric-appendiceal-abscess
#19
Chih-Cheng Luo, Kuang-Fu Cheng, Chen-Sheng Huang, Hung-Chieh Lo, Sheng-Mao Wu, Hung-Chang Huang, Wen-Kuei Chien, Ray-Jade Chen
BACKGROUND: In this study, we studied the therapeutic effectiveness of percutaneous drainage with antibiotics and the need for an interval appendectomy for treating appendiceal abscess in children with a research-oriented dataset released by the Bureau of National Health Insurance in Taiwan through the Collaboration Center for Health Information Application (CCHIA). METHODS: We identified 1225 patients under 18 years of age who had non-surgical treatment for an appendiceal abscess between 2007 and 2012 in a Taiwan CCHIA dataset...
October 18, 2016: BMC Surgery
https://www.readbyqxmd.com/read/27743607/-effect-of-compliance-with-an-antibiotic-prophylaxis-protocol-in-surgical-site-infections-in-appendectomies-prospective-cohort-study
#20
Tomás Sánchez-Santana, Juan Antonio Del-Moral-Luque, Pablo Gil-Yonte, Luis Bañuelos-Andrío, Manuel Durán-Poveda, Gil Rodríguez-Caravaca
BACKGROUND: Antibiotic prophylaxis is the most suitable tool for preventing surgical site infection. This study assessed compliance with antibiotic prophylaxis in surgery for acute appendicitis, and the effect of this compliance on surgical site infection. MATERIAL AND METHODS: Prospective cohort study to evaluate compliance with antibiotic prophylaxis protocol in appendectomies. An assessment was made of the level of compliance with prophylaxis, as well as the causes of non-compliance...
October 13, 2016: Cirugia y Cirujanos
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