Role of Intravenous Versus Home Oral Antibiotics in Perforated Appendicitis
Role of Intravenous Versus Home Oral Antibiotics in Perforated Appendicitis
To compare the effect of a single-agent home intravenous (IV) versus oral antibiotic therapy
 on complication rates and resource utilization following appendectomy for perforated
 appendicitis
Appendicitis is the most common cause of abdominal pain requiring emergent surgical
 intervention in children and approximately one third of patients present with perforation.
 Perforated appendicitis has been demonstrated to have a significant impact on patients and
 families due to the prolonged hospitalization, high complication rates, and tremendous
 economic burden from treatment. The most significant complication following operative
 treatment of perforated appendicitis is intra-abdominal abscess, which develops in
 approximately 20% of children following appendectomy in recent literature. Due to this
 frequent and morbid complication, continued research has been driven at determining the most
 efficacious and cost-effective postoperative antibiotic treatment regimen to reduce
 post-operative abscess. As postoperative abscess rates following appendectomy for perforated
 appendicitis remain high, the primary aim of this study was to evaluate a new postoperative
 antibiotic treatment regimen based on single daily dosing ertapenem while inpatient with
 randomization into ten day completion course of home antibiotics with IV ertapenem versus
 oral amoxicillin/clavulanate. The hypothesis is that the ertapenem based regimen will offer
 reduced rates of postoperative abscess, with no major difference between completion courses
 of home IV versus oral antibiotics.
Inclusion Criteria:

 -  Patients 4-17 years of age with perforated acute appendicitis diagnosed at time of
 appendectomy.

 Exclusion Criteria:

 -  Patients with a known severe allergy to penicillin (anaphylaxis), prior severe side
 effects from ertapenem or amoxicillin-clavulanate, pregnancy, or previous drainage
 procedure for abscess and/or fluid collection related to appendicitis.