2014, Number 2
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ABSTRACTBackground: complicated acute appendicitis (gangrenous or perforating) is the most common cause of secondary peritonitis in pediatric age. The treatment used in Cuba includes emergency operation and the use of broad-spectrum antimicrobials for about seven days.
Objective: to show the results of a new sequential antimicrobial treatment (intravenous/orally) in the postoperative period in children with complicated acute appendicitis.
Method: a quasi-experiment was conducted with all the children treated for complicated acute appendicitis in the Department of Pediatric Surgery of the Dr. Eduardo Agramonte Piña Provincial Teaching Pediatric Hospital of Camagüey from January 1st, 2010 to December 31st, 2012. Between the third and fifth days of the postoperative period, the parental treatment was replaced for cotrimoxazole and metronidazole administered orally. The results were compared to the series of patients treated during the previous three-year period (historical controls).
Results: a total of 129 children were included in the cases. The historical controls added up to 144. The average hospital stay was of 182 days/year (4.24 days/patient) for the cases and of 337 days/year (7.02 days/patient) for the controls. The costs were of $ 75 662.74 for the cases ($ 586.53/patient) and of $137 765.04 for the controls ($ 956.70/patient).
Conclusions: the data obtained in the study show a decrease of 2.78 days in the hospital stay and of around $ 370.17 per patient, when comparing both three-year periods.
Mamoon AA, Stephan H, Vernaz N, Kearney MP, Scott MG, Funston C, et al. Quasiexperimental study of the effects of antibiotic use, gastric acid-suppressive agents, and infection control practices on the incidence of Clostridium difficile-associated diarrhea in hospitalized patients. Antimicrob Agents Chemother. 2009 May;53(5):2082–8.
Bueno Rodríguez JC, Castelló González M, Aguilar Atanay D, Hernández Moore E. Uso secuencial de los antimicrobianos en los niños con apendicitis aguda complicada: estado de la cuestión. Rev Arch Med Camagüey [Internet]. Nov-Dic 2013 [citado 2 Nov 2013];17(6):[aprox. 15 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext & pid=S1025-02552013000600014 & lng=es & nrm=iso & tlng=es