Pediatric appendicitis and need for antibiotics at time of discharge: Does route of administration matter?

J Pediatr Surg. 2016 Jul;51(7):1170-3. doi: 10.1016/j.jpedsurg.2016.03.004. Epub 2016 Mar 12.


Introduction: Following complicated appendicitis, there are limited data available to guide the surgeon regarding antibiotic selection, specifically in regards to route of administration. We hypothesized that among children with appendicitis who are discharged home with antibiotic therapy, the post-discharge readmission and complication rates do not differ between those children who receive IV antibiotics and those who receive PO antibiotics.

Methods: We performed a retrospective review of all children discharged home on antibiotics following appendectomy at a single institution between 11/10-10/14. We compared outcomes including ED and hospital readmission rates, and development of postoperative complications, between those children who were discharged on IV antibiotics and those discharged on PO antibiotics.

Results: 325 children were discharged with antibiotics following appendectomy (n=291 PO antibiotics group; n=34 IV group). On both univariate and multivariate analysis, rate of each complication did not differ between the two groups including inpatient readmission (5% PO vs. 6% IV; p=0.8), ED readmission (10% vs. 11%; p=0.8), postdischarge complications related to the operation (10% vs. 15%; p=0.4), or abscess development post-discharge (4% vs. 3%; p=1).

Conclusions: Among children with complicated appendicitis who are discharged home with ongoing antibiotic therapy, our data demonstrate no differences in outcomes between those children who receive IV and PO antibiotics. Further data, collected in a prospective fashion, are needed to clarify the role of IV and PO antibiotics among children with perforated appendicitis.

Keywords: Appendicitis; Children; IV antibiotics; PO antibiotics.

Publication types

  • Comparative Study

MeSH terms

  • Administration, Oral
  • Adolescent
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / therapeutic use
  • Appendectomy
  • Appendicitis / drug therapy*
  • Appendicitis / surgery
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Female
  • Humans
  • Injections, Intravenous
  • Male
  • Patient Discharge
  • Patient Readmission / statistics & numerical data
  • Postoperative Care / methods*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Treatment Outcome


  • Anti-Bacterial Agents