WOFAPS 2025 8th World Congress of Pediatric Surgery

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Poster - 262

Comparison of Two Antibiotic Combinations for Conservative Treatment of Non-Complicated Acute Appendicitis in Children

Timurs Zurmutai 1, Arnis Eņģelis 1, Mohit Kakar 1, Astra Zviedre 2, Jurijs Bormotovs 3, Aigars Petersons 1
1 Riga Stradins University & Children's Clinical University Hospital, Department of Paediatric Surgery
2 Riga Stradins University, Department of Paediatric Surgery
3 Rigas Stradins University

Objective

Goal of study is to assess effectiveness of two different antibiotic regimens for conservative treatment of non-complicated acute appendicitis (AnA) in children.

Methods

A prospective randomized clinical trial (registered in European Union) is being conducted at a single tertiary care hospital and is in its final stage. Children between 7 and 18 years old, diagnosed with AnA were enrolled and randomly assigned to two different treatment groups. One group received ceftazidime/metronidazole (C/M), the other group received ampicillin/metronidazole (A/M). Both regimens were administered for 3 days. Blood leucocyte count, serum C-reactive protein, Interleukin-6, Interleukin-8, monocyte chemoattractant protein 1 were evaluated 3 times during hospital stay. Statistical analysis was done using linear regression method. 1-year recurrence rates of acute appendicitis (AA) for both groups were compared using logit regression method.

Results

Up to date 48 patients were included (C/M n=23, A/M n=25). Analysis showed no significant differences in evaluated blood and serum inflammatory markers (p>0.05 for all markers). No statistically significant difference in recurrence rate of AA was observed (OR=2.42, 97.5% CI: -0.085–0.268, p=0.336).

Conclusions

Preliminary results suggest that both antibiotic combinations are equally effective for managing AnA in children. This indicates that the choice of broader spectrum later generation antibiotics may not be crucial in treatment of AnA. We recommend consulting local antibiotic resistance guidelines. Use of metronidazole in both groups may be a limitation of this study. Further research is required for confirmation of these results.

Keywords: acute appendicitis, children, conservative treatment

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