Evidence map›Paper›PMID 41202087›Full record

ArticlePloS one2025

Assessing the Longitudinal outcomes of Piperacillin/tazobactam versus ceftriAxone and metronidazole for Children with perforated Appendicitis (ALPACA): A protocol for a pilot randomized controlled trial.

Daniel Briatico, Nadia Safa, Helene Flageole, Sarah Khan, Jeffrey Pernica, Mohamed Eltorki, Eyal Cohen, Michael H Livingston

Registry-linked trialAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05943223 (Assessing the Longitudinal Outcomes of Piperacillin/Tazobactam Versus ceftriAxone and Metronidazole for Children With Perforated Appendicitis), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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.

NCT05943223 phase2completednot on this map

Assessing the Longitudinal Outcomes of Piperacillin/Tazobactam Versus ceftriAxone and Metronidazole for Children With Perforated Appendicitis (ALPACA): a Randomized Controlled Trial

TypeinterventionalSponsorMcMaster Children's HospitalRan2024 to 2025Enrolled16ConditionsAppendicitis PerforatedArmsPiperacillin/tazobactam, Normal saline, CefTRIAXone Injection, Metronidazole Injection
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
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

8 authors.

Daniel BriaticoDivision of Pediatric Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.ORCID https://orcid.org/0000-0002-8665-9492
Nadia SafaDivision of Pediatric Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.ORCID https://orcid.org/0009-0009-5605-8619
Helene FlageoleDivision of Pediatric Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
Sarah KhanDivision of Pediatric Infectious Disease, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.ORCID https://orcid.org/0000-0001-8498-2643
Jeffrey PernicaDivision of Pediatric Infectious Disease, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.ORCID https://orcid.org/0000-0002-4380-5402
Mohamed EltorkiPediatric Emergency Medicine, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada.
Eyal CohenPaediatrics and Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Michael H LivingstonDivision of Pediatric Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute appendicitis is the most common indication for emergency surgery in children. In cases of perforation, patients require post-operative intravenous antibiotics in hospital. However, some children fail to respond adequately, resulting in prolonged hospitalization. The optimal antibiotic regimen for perforated appendicitis remains uncertain.

methodsWe propose a double-blind, randomized controlled pilot trial comparing two commonly used antibiotic strategies. Eligible participants include children <18 years undergoing laparoscopic appendectomy for perforated appendicitis. Following surgery, participants will be randomized to receive either: (1) piperacillin/tazobactam; or (2) ceftriaxone and metronidazole. The sample size for the pilot study is 16 participants (i.e., 8 per group). Feasibility outcomes include recruitment rate, protocol adherence, loss to follow-up, and cost per participant. DISCUSSION: This pilot study will assess the feasibility of conducting a blinded randomized controlled trial of postoperative antibiotic therapy in children with perforated appendicitis. To date, only one randomized trial has addressed this question, but it was limited by its single-center design, lack of blinding, and susceptibility to ascertainment bias and other methodological concerns. Findings from this pilot will inform the design of a larger, multicenter study with rigorous blinding and standardized outcome assessment to determine whether piperacillin-tazobactam or ceftriaxone and metronidazole provides superior outcomes.

trial registrationClinicalTrials.gov: NCT05943223.

Indexed as

Anti-Bacterial AgentsAppendicitisCeftriaxoneMetronidazolePiperacillin, Tazobactam Drug CombinationAdolescentAppendectomyChildChild, PreschoolDouble-Blind MethodFemaleHumansLongitudinal StudiesMalePilot ProjectsRandomized Controlled Trials as TopicAnti-Bacterial AgentsCeftriaxoneMetronidazolePiperacillin, Tazobactam Drug Combination

Identifiers

PMID41202087
PMCPMC12594383

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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.