A randomized clinical trial of ampicillin, gentamicin and clindamycin versus cefotaxime and clindamycin in children with ruptured appendicitis.
This prospective, randomized, double-blind study compares the efficacy, safety and cost-effectiveness of ampicillin, gentamicin and clindamycin (AGC) or cefotaxime and clindamycin (CC) for the treatment of children with complicated appendicitis. Ninety-seven children were randomized. Forty-seven were assigned to the AGC regimen and 50 received CC. Forty-two patients in the AGC group had an appropriate therapeutic outcome, whereas 48 of 50 children who received CC completed the trial successfully (p = NS). There were no differences between the groups with reference to the duration of antibiotic administration, fever, leukocytosis or length of hospitalization. Complications of therapy were uncommon and neither regimen demonstrated a significant advantage from an economic standpoint. We concluded that, in childhood, complicated appendicitis can be treated with either CC or AGC with equal efficacy.
Schropp
K P
KP
Ohio State University College of Medicine, Columbus 43205.
Kaplan
S
S
Golladay
E S
ES
King
D R
DR
Pokorny
W
W
Mollitt
D L
DL
Wise
W E
WE
Mason
E O
EO
D000293:Adolescent; D000667:Ampicillin / Q000009:adverse effects / Q000627:therapeutic use*; D001064:Appendicitis / Q000188:drug therapy* / Q000601:surgery; D002439:Cefotaxime / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002981:Clindamycin / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003362:Cost-Benefit Analysis; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005839:Gentamicins / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007416:Intestinal Perforation / Q000188:drug therapy* / Q000601:surgery; D008297:Male; D011292:Premedication; D011446:Prospective Studies; D012422:Rupture, Spontaneous; D013530:Surgical Wound Infection / Q000517:prevention & control
D005839:Gentamicins; D002981:Clindamycin; D000667:Ampicillin; D002439:Cefotaxime