ArticleWorld journal of pediatric surgery2026
Postoperative outcomes following institutional antibiotic protocol changes in complicated pediatric appendicitis.
Article in World journal of pediatric surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Complicated pediatric appendicitis carries substantial morbidity, including intra-abdominal abscess formation, surgical reintervention, and prolonged hospitalization. Empirical antibiotic therapy is a core component of management, yet when compared with disease severity its relative contribution to outcomes is poorly characterized in institutional practice settings. Methods: This retrospective before-after observational study was conducted at a tertiary hospital in Bogotá, Colombia. Pediatric patients with complicated appendicitis were compared across two sequential first-line empirical antibiotic protocol periods: amikacin plus metronidazole (period 1) changed to ampicillin-sulbactam (period 2). A multivariable logistic regression model was used to identify factors associated with intra-abdominal abscess formation. Results: A total of 220 patients were included (period 1, Conclusions: No differences in postoperative outcomes were observed between institutional antibiotic protocol periods. Disease severity, particularly generalized peritonitis, was the main factor associated with intra-abdominal abscess formation. These findings support prioritizing early severity assessment and source control over modifications in empirical antibiotic selection.
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