Antibiotic management of complicated appendicitis.
A prospective, randomized, double-blind clinical trial was undertaken comparing gentamicin, ampicillin, and clindamycin (GAC) to gentamicin, ampicillin, and placebo (GAP) in children with complicated appendicitis. Of the 64 patients enrolled in this study, 33 were assigned to the GAC group and 31 received GAP. A single GAC patient (3%) was considered a therapeutic failure in comparison to seven children (23%) in the GAP group (P less than 0.05). Duration of fever was significantly prolonged in the GAP patients (4.7 +/- .8 days versus 2.9 +/- .5 days) when compared to the clindamycin treated children (P less than 0.05). Duration of leukocytosis was 3.2 +/- .4 days for GAC patients and 4.9 +/- .9 days for those on the GAP protocol (P = 0.08). On the basis of this experience the routine use of gentamicin, ampicillin, and clindamycin is recommended for all children with complicated appendicitis.
D000667:Ampicillin / Q000008:administration & dosage*; D001064:Appendicitis / Q000150:complications / Q000188:drug therapy*; D002648:Child; D002981:Clindamycin / Q000008:administration & dosage*; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D010538:Peritonitis / Q000188:drug therapy / Q000209:etiology; D011446:Prospective Studies; D011897:Random Allocation; D013997:Time Factors
D005839:Gentamicins; D002981:Clindamycin; D000667:Ampicillin