Safety and Efficacy of Short-Course Intravenous Antibiotics after Complicated Appendicitis in Selected Patients

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dc.contributor.authorKroon, H.M.
dc.contributor.authorKenyon-Smith, T.
dc.contributor.authorNair, G.
dc.contributor.authorVirgin, J.
dc.contributor.authorThomas, B.
dc.contributor.authorJuszczyk, K.
dc.contributor.authorHollington, P.
dc.date.issued2023
dc.description.abstractBackground: After surgery for complicated appendicitis (CA), common practice is to treat all patients with a standardised long-course of intravenous antibiotics (IVAB) to reduce the risk of postoperative surgical infections (PSI). The aim of the current study was to evaluate the safety and efficacy of a short-course IVAB after CA in selected patients. Methods: The Department’s prospectively collected database identified CA patients treated between2015 and 2019. Baseline and treatment characteristics and postoperative outcomes were analysed. The cut-off between short- and long-course IVAB was 2 days. Outcomes of interest were PSI and 30-day unplanned readmission. Results: In total, 226 patients had CA: Ninety-nine CA (43.8%) received short-course IVAB and 127 (56.2%) received long-course. PSI occurred in 6% and 10% of the short-course and long-course patients, respectively (p¼0.34). Length of IVAB after a PSI was comparable to that of patients without PSI (median 3 and 2 days of IVAB respectively; p¼0.28). 30-day unplanned readmission rates were 7% and 6%, respectively (p¼0.99). Length of IVAB for readmitted patients was similar to those who were not readmitted (median 3 days of IVAB in both; p¼0.91). Multivariable analysis showed that the intraoperative findings of the appendix (p¼0.04) was a prognostic predictor for PSI. ASA score (p¼0.02) and surgical approach (p¼0.05) were prognostic predictors for 30-day unplanned readmission. Conclusions: This study shows that when patients respond well, a short-course IVAB can safely be applied after CA without increasing risk of PSI or 30-day unplanned readmission.
dc.description.statementofresponsibilityHidde M. Kroon, Tim Kenyon-Smith, Gavin Nair, James Virgin, Bev Thomas, Karolina Juszczyk and Paul Hollington
dc.identifier.citationActa Chirurgica Belgica, 2023; 123(1):49-53
dc.identifier.doi10.1080/00015458.2021.1940726
dc.identifier.issn0001-5458
dc.identifier.issn2577-0160
dc.identifier.orcidKroon, H.M. [0000-0002-8923-7527]
dc.identifier.urihttps://hdl.handle.net/2440/140251
dc.language.isoen
dc.publisherTaylor and Francis
dc.rights© 2021 The Royal Belgian Society for Surgery
dc.source.urihttps://doi.org/10.1080/00015458.2021.1940726
dc.subjectcomplicated appendicitis
dc.subjectcomplications
dc.subjectintravenous antibiotics
dc.subject.meshHumans
dc.subject.meshAppendicitis
dc.subject.meshPostoperative Complications
dc.subject.meshAnti-Bacterial Agents
dc.subject.meshPatient Readmission
dc.subject.meshAppendectomy
dc.subject.meshRisk Factors
dc.subject.meshRetrospective Studies
dc.titleSafety and Efficacy of Short-Course Intravenous Antibiotics after Complicated Appendicitis in Selected Patients
dc.typeJournal article
pubs.publication-statusPublished

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