Bacterial Pathogens and Antibiotic Resistance Patterns in Pediatric Appendicitis: Implications for Antibiotic Choice - PubMed
4 hours ago
- #antibiotic resistance
- #bacterial pathogens
- #pediatric appendicitis
- Acute appendicitis is the most common cause for an acute abdomen worldwide, with laparoscopic appendectomy being the standard treatment.
- Perioperative antibiotic therapy reduces postoperative complications, but conservative treatments are still under evaluation, especially in pediatric cases.
- The study analyzed 181 pediatric patients with appendicitis at a German referral center, focusing on bacterial pathogens and antibiotic resistance patterns.
- Common pathogens identified were Escherichia coli (31%), Streptococcus anginosus group (21%), Bacteroides fragilis (15%), and Pseudomonas aeruginosa (9%).
- Pseudomonas and S. anginosus group were significantly associated with perforated appendicitis.
- High resistance rates were found for ampicillin/sulbactam (31%), cefuroxime/ceftriaxone (37%), and ciprofloxacin (51%), mostly due to intrinsic resistance.
- Low resistance was observed for cefuroxime/metronidazole (17%), piperacillin/tazobactam (8%), and meropenem (3%).
- Perforation, fever, and higher C-reactive protein levels were linked to resistance against cefuroxime/metronidazole.
- The study recommends cefuroxime/metronidazole for uncomplicated cases and piperacillin/tazobactam for complicated appendicitis.