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Antibiotics appendicitis

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https://www.readbyqxmd.com/read/29148199/five-lessons-in-uncomplicated-appendicitis-can-we-remove-the-surgery
#1
Andrew Read, Jane Xu, Susan Adams, Jonathan Karpelowsky
Appendicectomy has remained the treatment of choice for appendicitis for over a century and is the most commonly performed emergency operation in children. However, emerging evidence suggests that appendicectomy may not always be necessary in uncomplicated appendicitis, with early paediatric trials demonstrating that antibiotic-only therapy can be safe and effective. Further rigorously designed and appropriately powered studies are necessarily to establish the place of non-operative management of uncomplicated appendicitis in the future...
November 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29146647/initial-non-operative-management-of-uncomplicated-appendicitis-in-children-a-protocol-for-a-multicentre-randomised-controlled-trial-apac-trial
#2
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
https://www.readbyqxmd.com/read/29146633/comparison-of-outcomes-of-antibiotic-drugs-and-appendectomy-coda-trial-a-protocol-for-the-pragmatic-randomised-study-of-appendicitis-treatment
#3
Giana H Davidson, David R Flum, David A Talan, Larry G Kessler, Danielle C Lavallee, Bonnie J Bizzell, Farhood Farjah, Skye D Stewart, Anusha Krishnadasan, Erin E Carney, Erika M Wolff, Bryan A Comstock, Sarah E Monsell, Patrick J Heagerty, Annie P Ehlers, Daniel A DeUgarte, Amy H Kaji, Heather L Evans, Julianna T Yu, Katherine A Mandell, Ian C Doten, Kevin S Clive, Karen M McGrane, Brandon C Tudor, Careen S Foster, Darin J Saltzman, Richard C Thirlby, Erin O Lange, Amber K Sabbatini, Gregory J Moran
INTRODUCTION: Several European studies suggest that some patients with appendicitis can be treated safely with antibiotics. A portion of patients eventually undergo appendectomy within a year, with 10%-15% failing to respond in the initial period and a similar additional proportion with suspected recurrent episodes requiring appendectomy. Nearly all patients with appendicitis in the USA are still treated with surgery. A rigorous comparative effectiveness trial in the USA that is sufficiently large and pragmatic to incorporate usual variations in care and measures the patient experience is needed to determine whether antibiotics are as good as appendectomy...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29146455/successful-nonoperative-management-of-uncomplicated-appendicitis-predictors-and-outcomes
#4
Tyler J Loftus, Scott C Brakenridge, Chasen A Croft, R Stephen Smith, Philip A Efron, Frederick A Moore, Alicia M Mohr, Janeen R Jordan
BACKGROUND: Our objective was to identify predictors of successful nonoperative management (NOM) of uncomplicated appendicitis. We hypothesized that the absence of diabetes, absence of an appendicolith, short duration of symptoms, absence of systemic inflammation, and low modified Alvarado score would predict successful NOM. METHODS: We performed a retrospective cohort analysis of 81 consecutive patients who underwent NOM of uncomplicated appendicitis. Successful NOM was defined as resolution of appendicitis with antibiotics alone and no recurrent appendicitis within 180 days...
November 13, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29101666/laparoscopic-appendectomy-vs-antibiotic-therapy-for-acute-appendicitis-a-propensity-score-matched-analysis-from-a-multicenter-cohort-study
#5
Gaetano Poillucci, Lorenzo Mortola, Mauro Podda, Salomone Di Saverio, Laura Casula, Chiara Gerardi, Nicola Cillara, Luigi Presenti
Acute appendicitis (AA) is among the most common causes of acute lower abdominal pain leading patients to the emergency department. Significant debate remains on whether AA should be operated or not. A propensity score-matched analysis was performed in seven Italian Hospitals, with the aim to assess safety and feasibility both nonoperative management with antibiotics (AT) and surgical therapy with appendectomy (ST) for patients with AA. Data regarding all patients discharged from the participating centers with a diagnosis of appendicitis from January 1st, 2014 to December 31st, 2014 were collected retrospectively...
November 3, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/29098095/medical-approach-to-right-colon-diverticulitis-with-perforation
#6
James Espinosa, Rahul Sharma, Alan Lucerna, Doug Stranges
We report a case of a 71-year-old female who presented with right lower quadrant (RLQ) abdominal pain and was diagnosed on CT scan with right-sided diverticulitis with perforation. She was admitted under the surgical service after consultation and received intravenous fluids, intravenous antibiotics, and pain medications as needed. The patient was discharged 2 days after admission in stable condition with follow-up with gastroenterology. The differential diagnosis of right lower quadrant abdominal pain is vast...
2017: Case Reports in Emergency Medicine
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
#7
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/29066523/non-operative-management-of-appendicitis-in-children
#8
REVIEW
Nigel J Hall, Simon Eaton
While appendicectomy has been considered the mainstay of treatment for children with acute appendicitis for many decades, there has been a great deal of recent interest in non-operative treatment (NOT) with antibiotics alone. Initial results suggest that many children with appendicitis can indeed be safely treated with NOT and can be spared the surgeon's knife. Many as yet unanswered questions remain, however, before NOT can be considered a realistic and reliable alternative to surgery. This review summaries current knowledge and understanding of the role of NOT in children with appendicitis and outlines and discusses the outstanding knowledge gaps...
October 24, 2017: Archives of Disease in Childhood
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
#9
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
#10
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
#11
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/29032983/early-versus-late-surgical-management-of-complicated-appendicitis-in-children-a-statewide-database-analysis-with-one-year-follow-up
#12
Saurabh Saluja, Tianyi Sun, Jialin Mao, Shaun A Steigman, P Stephen Oh, Heather L Yeo, Art Sedrakyan, Demetri J Merianos
BACKGROUND: Complicated appendicitis is common in children, yet the timing of surgical management remains controversial. Some support initial antibiotics with delayed operation whereas others support immediate operation. While a few randomized trials have evaluated this question, they have been small, single-center trials with limited follow-up. We present a database analysis of outcomes in early versus late surgical management of complicated appendicitis with one-year follow-up. METHODS: We conducted a retrospective review of children with complicated appendicitis presenting between 2000 and 2013, utilizing a New York State database...
October 2, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29027898/surgery-versus-antibiotics-for-uncomplicated-appendicitis-which-would-a-medical-student-want
#13
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/29016242/early-predictors-of-abscess-development-after-perforated-pediatric-appendicitis
#14
Catherine M Dickinson, Nathan A Coppersmith, Francois I Luks
BACKGROUND: Approximately one-third of children with appendicitis present with advanced disease or perforation. Whereas this increases the risk for post-operative complications and re-admission, it is not yet possible to predict early on who will develop an abdominal abscess. We sought to identify specific risk factors for this complication, in an attempt to streamline post-operative care. PATIENTS AND METHODS: We reviewed the records of all cases of perforated appendicitis over a 12-month period at a tertiary children's hospital...
October 10, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28990753/novel-electrophilic-scaffold-for-imaging-of-essential-penicillin-binding-proteins-in-streptococcus-pneumoniae
#15
Shabnam Sharifzadeh, Michael J Boersma, Ozden Kocaoglu, Alireza Shokri, Clayton L Brown, Joshua D Shirley, Malcolm E Winkler, Erin E Carlson
Peptidoglycan (PG) is a mesh-like heteropolymer made up of glycan chains cross-linked by short peptides and is the major scaffold of eubacterial cell walls, determining cell shape, size, and chaining. This structure, which is required for growth and survival, is located outside of the cytoplasmic membrane of bacterial cells, making it highly accessible to antibiotics. Penicillin-binding proteins (PBPs) are essential for construction of PG and perform transglycosylase activities to generate the glycan strands and transpeptidation to cross-link the appended peptides...
November 17, 2017: ACS Chemical Biology
https://www.readbyqxmd.com/read/28952357/nonoperative-management-of-appendicitis
#16
Andrew Scott, Steven L Lee, Daniel A DeUgarte, Stephen B Shew, James C Y Dunn, Shant Shekherdimian
We evaluated the outcomes for nonoperative management (NOM) of all children with suspected nonperforated appendicitis, including those patients with an appendicolith. Parents of all children with suspected nonperforated appendicitis were offered NOM versus laparoscopic appendectomy. NOM included administration of intravenous antibiotics and hospital admission. If no improvement within 24 hours, laparoscopic appendectomy was performed. Primary outcomes were initial success rate and recurrence rate. Fifty patients selected NOM...
March 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28946163/dual-versus-triple-antibiotics-regimen-in-children-with-perforated-acute-appendicitis
#17
Yael Dreznik, Elad Feigin, Inbal Samuk, Dragan Kravarusic, Artur Baazov, Itzhak Levy, Gilat Livni, Enrique Freud
No abstract text is available yet for this article.
September 25, 2017: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28942236/increased-incidence-of-bowel-cancer-after-non-surgical-treatment-of-appendicitis
#18
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
#19
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/28938269/antibiotics-versus-surgical-therapy-for-uncomplicated-appendicitis-contrasting-interpretations-of-data
#20
Peter F McAnena, Oliver J McAnena, Michael J Kerin
No abstract text is available yet for this article.
September 21, 2017: Annals of Surgery
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