Comparison of the efficacy of carbapenems and cephalosporins for postoperative treatment of perforated appendicitis in children

Background: Pediatric perforated appendicitis is a severe acute condition requiring abdominal surgery followed by postoperative antibiotics. Antibiotic choices vary significantly among children's medical centers, and the optimal postoperative anti-infective treatment for perforated appendicitis is unclear. Objective To investigate the pathogenic bacterial characteristics and the appropriate use of antibiotics in children with perforated appendicitis. Methods We retrospectively analyzed the records of 65 children (43 boys and 22 girls, mean age 6.92 ± 3.41 years) with perforated appendicitis admitted to the Department of Pediatric Surgery at our hospital between December 2019 and August 2022 and descriptively analyzed the drug-resistance characteristics of the common pathogenic bacteria. Patients were divided into carbapenem (CBP) group (32 cases) and cephalosporin (CPS) group (33 cases) according to the antibiotic type administered. C-reactive protein (CRP) recovery time, gastrointestinal function (GF) recovery time, hospital stay length, and postoperative complication incidence, were compared between the groups. Results Escherichia coli and Pseudomonas aeruginosa were the most common pathogens associated with perforated appendicitis. For the CBP and CPS groups, the CRP recovery times were (8.50 ± 3.57 )days and (6.85 ± 1.70 )days, respectively ( P  = 0.020).The GF recovery times were (37.63 ± 22.00 )hours and (36.26 ± 22.45)hours, respectively ( P  = 0.805 ).The Hospital stay length were ( 9.56 ± 3.48 )days and ( 8.06 ± 1.95 )days, respectively ( P  = 0.104 ).The over all