title: [Comparison of two protocols of prophylactic antibiotic therapy in childhood appendectomy].
abstract: OBJECTIVE
  Antibiotic administration during acute appendicitis in children continues to be debated. The purpose of this study was to compare efficacy of two prophylactic antibiotic treatment guidelines in acute appendicitis and peritonitis in children.
  
  
  METHODS
  The infectious complication rate after appendicectomy was compared during two distinct periods (before/after study). During the first period, the guidelines for antibiotic administration were based on ticarcillin-clavulanic acid. During the second period, the guidelines were based on amoxicillin-clavulanic acid for non-perforated appendicitis or appendicitis with localized peritonitis, and clavulanic acid was reserved for general peritonitis. All children younger than 16 years of age who underwent appendicectomy during the periods studied were included. Data were retrospectively collected from surgical and anesthetics charts.
  
  
  RESULTS
  Ninety-five children during the first period and 238 during the second were included. In the children with non-perforated appendicitis, no postoperative infectious complication occurred in 74 children during the first period versus two out of 153 (1%) during the second period. In cases of perforated appendicitis, postoperative infectious complications occurred two cases (10%) during the first period versus nine (11%) during the second. There were no significant differences between the two periods.
  
  
  CONCLUSIONS
  In this population, antibiotic administration guidelines based on amoxicillin-clavulanic acid for stages I-III of appendicitis maintained a low rate of postoperative infectious complications and were not associated with a higher postoperative infectious complication rate than guidelines based on ticarcillin-clavulanic acid.
authors.affiliation: Service d'anesthésie-réanimation, hôpital Nord, Assistance publique-Hôpitaux de Marseille, chemin des Bourrelly, 13915 Marseille cedex 20, France.
authors.forename: C
authors.initials: C
authors.lastname: Bechis
authors.affiliation: Service d'anesthésie-réanimation, hôpital Nord, Assistance publique-Hôpitaux de Marseille, chemin des Bourrelly, 13915 Marseille cedex 20, France; UMR 7268 ADèS, espace éthique méditerranéen, hôpital de la Timone, Aix-Marseille université, 265, rue Saint-Pierre, 13005 Marseille, France. Electronic address: fabrice.michel@ap-hm.fr.
authors.forename: F
authors.initials: F
authors.lastname: Michel
authors.affiliation: Service de chirurgie infantile, hôpital Nord, Assistance publique-Hôpitaux de Marseille, chemin des Bourrelly, 13915 Marseille cedex 20, France.
authors.forename: T
authors.initials: T
authors.lastname: Merrot
authors.affiliation: Service de chirurgie infantile, hôpital Nord, Assistance publique-Hôpitaux de Marseille, chemin des Bourrelly, 13915 Marseille cedex 20, France.
authors.forename: P
authors.initials: P
authors.lastname: Nicoleta
authors.affiliation: Service d'anesthésie-réanimation, hôpital Nord, Assistance publique-Hôpitaux de Marseille, chemin des Bourrelly, 13915 Marseille cedex 20, France.
authors.forename: A
authors.initials: A
authors.lastname: Lando
authors.affiliation: Service d'anesthésie-réanimation, hôpital Nord, Assistance publique-Hôpitaux de Marseille, chemin des Bourrelly, 13915 Marseille cedex 20, France.
authors.forename: M
authors.initials: M
authors.lastname: Leone
authors.affiliation: Service d'anesthésie-réanimation, hôpital Nord, Assistance publique-Hôpitaux de Marseille, chemin des Bourrelly, 13915 Marseille cedex 20, France.
authors.forename: C
authors.initials: C
authors.lastname: Martin
mesh_terms: D000293:Adolescent; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001062:Appendectomy; D001064:Appendicitis / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D002969:Clavulanic Acids / Q000627:therapeutic use; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D010538:Peritonitis / Q000188:drug therapy*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D013982:Ticarcillin / Q000627:therapeutic use
chemical_list: D002969:Clavulanic Acids; D019980:Amoxicillin-Potassium Clavulanate Combination; C043215:ticarcillin-clavulanic acid; D013982:Ticarcillin