Antibacterial therapy for non-complicated appendicitis in children: problem of choice

Research output: Contribution to conferenceAbstractpeer-review


Recent decade showed increased use of non-operative antibacterial treatment (NOT) for pediatric acute non-complicated appendicitis (NAA). Multiple randomized controlled trials(RCT) comparing operative treatment (OT) and NOT approach show possible feasibility of non-surgical approach in NAA. Preliminary literature review showed numerous different antibiotic drug combinations used for NAA treatment. Thus a problem of choice was raised - which antibiotic drug combination to choose? A concise literature review was performed.  A list of antibiotic drugs and their combinations used for treatment of NAA in children was formed.  Lack of RCTs regarding NOT of pediatric NAA was discovered. Two meta-analysis by Xu et al. and Georgiou et al. allowed to form a list of 18 different antibiotic drugs used for NOT of pediatric NAA. Initial treatment success varied form 58% to 100% with subsequent appendectomy varying from 4.2% to 27% of cases.  Children Clinical University Hospital in Riga uses i/v apmicillin/metronidazole combination for NOT and reports 13.5% recurrance rate of acute appendicitis. RCTs comparing different choice of antibacterial therapy for pediatric NAA are lacking. Several systematic analysis and meta-analysis studies showed necessity for further prospective randomized studies regarding NOT treatment of AA.Authors have the proposition to perform an RCT to compare clinical safety, efficacy and  cost-efficiency  of 72h  i/v ampicillin and metronidozole combination following 7 days of p/o amoxiclav -  the existent standart of care method for treating non-complicated appendicitis with a prospected 72h i/v ceftazidime and metronidazole following 7 days of p/o amoxiclav. Study is expected to show additiona insight in feasibility of NOT of NAA for pediatric population
Original languageEnglish
Publication statusPublished - 24 Mar 2021
EventRSU Research week 2021: Knowledge for Use in Practice - Rīga, Latvia
Duration: 24 Mar 202126 Mar 2021


ConferenceRSU Research week 2021: Knowledge for Use in Practice
Abbreviated titleRW2021
Internet address

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 3.4. Other publications in conference proceedings (including local)


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