title: Once Daily Dosing of Ceftriaxone and Metronidazole in Children With Perforated Appendicitis.
abstract: OBJECTIVE
  The aim of this study was to compare hospital length of stay and rate of infectious complications in children with perforated appendicitis based on the postoperative antibiotic administered.
  
  
  METHODS
  This study was a retrospective analysis of children with perforated appendicitis who underwent an appendectomy at a large academic medical center from 2008 to 2013. The primary outcome was hospital length of stay. The secondary outcomes were rates of abscess formation, wound infection, and 30-day readmissions.
  
  
  RESULTS
  One hundred and twenty-three patients were included. Sixty-six patients (53%) were administered ceftriaxone and metronidazole once daily; 57 (47%) were administered other antibiotic regimens, which consisted of single, double, or triple antibiotic therapy with a beta-lactam backbone. There was no difference between the groups in terms of postoperative length of stay (5.7 versus 5.8 days, p = 0.83), postoperative abscess rate (8% versus 4%, p = 0.57), postoperative wound infection rate (5% versus 2%, p = 0.73), and 30-day readmissions (3% versus 11%, p = 0.19).
  
  
  CONCLUSIONS
  While there was no statistically significant difierence in the outcomes evaluated, the rate of infectious complications was twofold higher in those given ceftriaxone and metronidazole than in others. A larger prospective randomized controlled trial is warranted to better understand the risks of using these agents.
authors.affiliation: Department of Pharmacy, Texas Children's Hospital, Houston, Texas.
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Lee
authors.affiliation: University of Florida College of Pharmacy, Gainesville, Florida.
authors.forename: Saudia
authors.initials: S
authors.lastname: Ally
authors.affiliation: Department of Pharmacy, University of Florida Health Shands Hospital.
authors.forename: Brian
authors.initials: B
authors.lastname: Kelly
authors.affiliation: Department of Pediatric Surgery, University of Florida Health Shands Hospital, Gainesville, Florida.
authors.forename: David
authors.initials: D
authors.lastname: Kays
authors.affiliation: Department of Pharmacy, University of Florida Health Shands Hospital.
authors.forename: Lisa
authors.initials: L
authors.lastname: Thames
keywords: antibiotics; appendectomy; ceftriaxone; metronidazole; pediatrics; perforated appendicitis