Cessation of Antibiotics for Complicated Appendicitis at Discharge Does Not Increase Risk of Post-operative Infection
Topic overview
Retrospective study comparing outcomes in pediatric complicated appendicitis with and without discharge antibiotics. No significant differences found in postoperative infections or length of stay, suggesting discontinuing home antibiotics at discharge is safe in clinically stable patients.
Key takeaways
- Discontinuing home antibiotics after complicated pediatric appendicitis did not increase post-operative infection rates (7% vs 7.4%, p=1.0)
- Response-based inpatient IV antibiotics until clinical improvement may be sufficient without home antibiotic continuation
- Eliminating home antibiotics did not affect length of stay (4.5 vs 3.95 days) or secondary outcomes including readmission
- Current practice of routine home antibiotics for complicated appendicitis (83% in pre-protocol cohort) lacks evidence support
- Protocol change reduced antibiotic exposure without compromising safety, potentially decreasing C. difficile risk and antibiotic resistance
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