Behandeling met intraveneuze antibiotica versus een combinatie van intraveneus en oraal bij geperforeerde appendicitis

Perforated appendicitis is a common condition in children, for which intravenous antibiotics are standard medical management after appendectomy. However, duration and route of antibiotic administration vary among several centers. The objective of this study was to investigate whether there are randomized clinical trials in which the effects of treatment with long-term intravenous antibiotics are compared with short-term intravenous antibiotic therapy and conversion to oral antibiotics. Two randomized clinical trials were found and one retrospective study. In these studies, conversion to oral antibiotics was achieved when the patient was able to tolerate a regular diet. In two of the three studies, the patient also had to be afebrile. Outcome measures were postoperative abscess formation and duration of hospitalization. All three studies did not find a significant difference in rate of postoperative abscess formation. In two studies significant difference in duration of hospitalization was observed. According to these results, completing the course of antibiotics orally can be achieved safely.