Evidence map›Paper›PMID 41186640›Full record

SynthesisPediatric surgery international2025

Piperacillin/tazobactam versus ceftriaxone/metronidazole for children with perforated appendicitis: a systematic review and meta-analysis.

Jennifer Armstrong, Jhanahan Sriranjan, Daniel Briatico, Sarah Khan, Mohamed Eltorki, Michael H Livingston

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in Pediatric surgery international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jennifer ArmstrongMeharry Medical College, Nashville, TN, USA.
Jhanahan SriranjanDepartment of Pediatrics, Faculty of Health Sciences, McMaster University , Hamilton, ON, Canada.
Daniel BriaticoMcMaster Pediatric Surgery Research Collaborative, McMaster University , Hamilton, ON, Canada.
Sarah KhanDepartment of Pediatrics, Faculty of Health Sciences, McMaster University , Hamilton, ON, Canada.
Mohamed EltorkiDepartment of Pediatrics, Faculty of Health Sciences, McMaster University , Hamilton, ON, Canada.
Michael H LivingstonMcMaster Pediatric Surgery Research Collaborative, McMaster University , Hamilton, ON, Canada. livingm@mcmaster.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMost children with acute appendicitis are treated with laparoscopic appendectomy followed by antibiotics if the appendix is found to be perforated. There is variation in the type of post-operative antibiotics used for these patients.

methodsWe conducted systematic searches of Medline, Embase, and Cochrane for comparative studies of children with perforated appendicitis treated with post-operative piperacillin/tazobactam versus ceftriaxone and metronidazole.

resultsWe identified four studies consisting of 25,730 children with perforated appendicitis treated with laparoscopic appendectomy followed by post-operative piperacillin/tazobactam (n = 9,950) or ceftriaxone and metronidazole (n = 15,780). One study was a randomized controlled trial (RCT) and three were multicenter observational studies. Meta-analysis suggested no differences between piperacillin/tazobactam and ceftriaxone and metronidazole in terms of deep/organ-space surgical site infection (risk ratio [RR] = 0.97, 95% confidence interval [CI] 0.57-1.65), post-operative imaging (RR = 0.99, 95% CI 0.71-1.37), return to the emergency department (RR = 0.82, 95% CI 0.50-1.37), and readmission to hospital (RR = 0.85, 95% CI 0.45-1.62). Heterogeneity between studies was substantial (I

conclusionThis systematic review suggests that there is ongoing uncertainty regarding the optimal post-operative antibiotics for children with perforated appendicitis. CLINICAL

trial registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42023421492 .

Indexed as

Anti-Bacterial AgentsAppendicitisCeftriaxoneMetronidazolePiperacillin, Tazobactam Drug CombinationAppendectomyChildHumansLaparoscopyAnti-Bacterial AgentsCeftriaxoneMetronidazolePiperacillin, Tazobactam Drug CombinationAnti-bacterial agentsAppendectomyAppendicitisCeftriaxonePiperacillin

Identifiers

PMID41186640

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.