Two Different Antibiotics Versus One Antibiotic for Pediatric Perforated Appendicitis
Two Different Antibiotics Versus One Antibiotic for Pediatric Perforated Appendicitis
After appendix has been removed for perforated appendicitis, patients will receive
 postoperative antibiotics. In the last 5 years, the literature has transitioned from a 3
 -drug therapy to 2-drug therapy. Now there is a recent literature suggesting a single-drug
 therapy may be safe and adequate. In fact, using zosyn (piperacillin-tazobactam) as a
 single-drug therapy, there are additional benefits of simplicity, compliance, and lower
 infectious complications. Currently surgeons are already using both 2-drug regimen
 (ceftriaxone/metronidazole) and single-drug regimen (zosyn) interchangeable as both are FDA
 approved and regulated antibiotics for intra-abdominal infection. There is a clear need to
 compare outcomes between these two options.
The diagnosis of perforated appendicitis will be documented intraoperatively with photos of
 extraluminal fecal contents or visible holes on the appendix. Patients will be randomized to
 121 in each arm. Postoperative antibiotic therapy option will be decided based on blinded
 sequence model. 30 day postoperative follow up visit or calls will be made to assess and
 collect infectious complications.
Inclusion Criteria:

 -  Postoperative Perforated Appendicitis (documented by intraoperative photo)

 -  Postoperative Laparoscopic Appendectomy

 Exclusion Criteria:

 -  Nonperforated Gangrenous Appendicitis

 -  Nonperforated Purulent Appendicitis

 -  Open Appendectomy