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Original Article

Postoperative Monotherapy with Piperacillin-Tazobactam versus Multidrug Therapy with Cefotaxime and Metronidazole for Perforated Appendicitis in Children: A Case-Control Study

Sung-Jin Chun1, Dae Yeon Kim2, Seong-Chul Kim2, Jung-Man Namgoong2
Journal of the Korean Association of Pediatric Surgeons 2015;21(2):28-31.
Published online: December 22, 2015

1Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

2Division of Pediatric Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Correspondence: Dae Yeon Kim, Division of Pediatric Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. Tel: +82-2-3010-3961, Fax: +82-2-3010-6841, kimdy@amc.seoul.kr
• Received: October 2, 2015   • Revised: November 20, 2015   • Accepted: November 24, 2015

Copyright © 2015 by the Korean Association of Pediatric Surgeons

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    Recent data suggest that monotherapy with a broad-spectrum antibiotic may be as efficacious as, and potentially less costly than, standard multi-drug therapy. We compared mono-therapy with intravenous piperacillin-tazobactam (PT) with multi-drug therapy with cefotaxime and metronidazole (CM) in aspect of postoperative complications and hospital stay.
  • Methods
    We reviewed the hospital records and medical costs of the pediatric patients who were managed for perforated appendicitis between April 2013 and May 2014 retrospectively.
  • Results
    Forty-six patients with laparoscopic appendectomy for perforated appendicitis were included in our study. PT group was 20 and CM group was 26 patients. On admission, there were no significance in sex distribution, duration of symptoms, leukocyte count, and CRP levels. At postoperative third, fifth, and seventh day of each regimen, PT group have no statistical difference with CM group in leukocyte count, percentage of neutrophil, and CRP. There was no difference in abscess formation rate, wound infections, and hospital stay between two groups. There was only one patient who was readmitted with elevation of CRP and leukocyte count in CM group.
  • Conclusion
    Daily dosing with the mono-therapy of PT offers as efficient as multi-drug therapy of CM. To evaluate the efficacy of broad-spectrum antibiotics monotherapy in perforated appendicitis children, the cohort included more patients should be needed.
  • Keywords: Appendicitis; Piperacillin-tazobactam monotherapy; Cefotaxime; Metronidazole

No potential conflict of interest relevant to this article was reported.

The abstract of this article was presented at the 66th Annual Congress of the Korean Surgical Society, November 28, 2014.

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Table 1
Perioperative Patients Characteristics and Laboratory Findings

Values are presented as ratio, mean±SD, or n (%).

PT, piperacillin-tazobactam; CM, cefotaxime and metronidazole.

jkaps-21-28-i001.jpg
Table 2
Perioperative and Postoperative Findings

Values are presented as mean±SD, ratio, or n (%).

PT, piperacillin-tazobactam; CM, cefotaxime and metronidazole.

jkaps-21-28-i002.jpg
Table 3
Inflammatory Index according to the Postoperative Day (POD)

Values are presented as mean±SD or n (%).

PT, piperacillin-tazobactam; CM, cefotaxime and metronidazole.

jkaps-21-28-i003.jpg
Table 4
FFS vs. DRG

Values are presented as mean±SD.

FFS, fee for service; DRG, diagnosis related group; PT, piperacillin-tazobactam; CM, cefotaxime and metronidazole; KRW, Korean Won.

jkaps-21-28-i004.jpg

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Postoperative Monotherapy with Piperacillin-Tazobactam versus Multidrug Therapy with Cefotaxime and Metronidazole for Perforated Appendicitis in Children: A Case-Control Study
J Korean Assoc Pediatr Surg. 2015;21(2):28-31.   Published online December 22, 2015
DOI: https://doi.org/10.13029/jkaps.2015.21.2.28
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
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Include:
Postoperative Monotherapy with Piperacillin-Tazobactam versus Multidrug Therapy with Cefotaxime and Metronidazole for Perforated Appendicitis in Children: A Case-Control Study
J Korean Assoc Pediatr Surg. 2015;21(2):28-31.   Published online December 22, 2015
DOI: https://doi.org/10.13029/jkaps.2015.21.2.28
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Postoperative Monotherapy with Piperacillin-Tazobactam versus Multidrug Therapy with Cefotaxime and Metronidazole for Perforated Appendicitis in Children: A Case-Control Study
Postoperative Monotherapy with Piperacillin-Tazobactam versus Multidrug Therapy with Cefotaxime and Metronidazole for Perforated Appendicitis in Children: A Case-Control Study

Perioperative Patients Characteristics and Laboratory Findings

Values are presented as ratio, mean±SD, or n (%).

PT, piperacillin-tazobactam; CM, cefotaxime and metronidazole.

Perioperative and Postoperative Findings

Values are presented as mean±SD, ratio, or n (%).

PT, piperacillin-tazobactam; CM, cefotaxime and metronidazole.

Inflammatory Index according to the Postoperative Day (POD)

Values are presented as mean±SD or n (%).

PT, piperacillin-tazobactam; CM, cefotaxime and metronidazole.

FFS vs. DRG

Values are presented as mean±SD.

FFS, fee for service; DRG, diagnosis related group; PT, piperacillin-tazobactam; CM, cefotaxime and metronidazole; KRW, Korean Won.

Table 1 Perioperative Patients Characteristics and Laboratory Findings

Values are presented as ratio, mean±SD, or n (%).

PT, piperacillin-tazobactam; CM, cefotaxime and metronidazole.

Table 2 Perioperative and Postoperative Findings

Values are presented as mean±SD, ratio, or n (%).

PT, piperacillin-tazobactam; CM, cefotaxime and metronidazole.

Table 3 Inflammatory Index according to the Postoperative Day (POD)

Values are presented as mean±SD or n (%).

PT, piperacillin-tazobactam; CM, cefotaxime and metronidazole.

Table 4 FFS vs. DRG

Values are presented as mean±SD.

FFS, fee for service; DRG, diagnosis related group; PT, piperacillin-tazobactam; CM, cefotaxime and metronidazole; KRW, Korean Won.

Table 1

Table 2

Table 3

Table 4

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