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Query: UMLS:C0085693 (acute appendicitis)
 3,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The pharmocokynetics of a semisynthetic penicillin-ampicillin in acute appendicitis in children has been studied. Intramuscular and intravenous injections of 12,5 mg/kg and 25 mg/kg single doses of the antibiotic were administered. 50 children aged from 4 to 14 years were examined. Both ways of administration led to the creation of the ampicillin therapeutic concentration in the blood serum, but in case of intramuscular injection the circulation of the antibiotic in the blood was more prolonged. With the increase of the dose the antibiotic concentration in the blood and tissues of the abdominal cavity rises but without any significant prolongation of its circulation time in the blood.
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PMID:[Pharmacokinetics of ampicillin in acute appendicitis in children]. 64 96

In an investigation of 68 consecutive patients over the 60 operated on for acute appendicitis in 1969--1972 the symptoms and signs did not differ notably from those in younger patients. However, the disease was more advanced in the elderly patients with perforation of the appendix in 49%. Postoperative complications occurred in about one third of the series, but were never fatal. Use of broad-spectrum antibiotics (ampicillin) is recommended. The investigation showed that it is possible to reduce the mortality from acute appendicitis in elderly patients to a level comparable to that in younger ones.
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PMID:Acute appendicitis in patients over sixty. 68 31

Yersinia pseudotuberculosis infections in two bacteriologically confirmed cases are described. A child was found to have mesenteric adenitis and an adult had septicemia. Invariably simulating acute appendicitis, mesenteric adenitis most often occurs in male children and adolescents. Septicemia with this organism usually affects elderly, debilitated patients, who frequently have chronic hepatic disease. The infrequent diagnosis of infection with Yersinia pseudotuberculosis in the United States is probably due to failure to consider it a human pathogen. Currently classified with the Enterobacteriaceae, Yersinia pseudotuberculosis in a non-lactose-fermenting, Gram-negative coccobacillus. It is sensitive to a wide range of antibiotics, including tetracycline and streptomycin, but usually is resistant to ampicillin. Yersinia pseudotuberculosis has a worldwide distribution in wild and domestic mammals and birds. Infections in man may result from direct contact with infected animals or their excreta.
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PMID:Clinical and laboratory aspects of Yersinia pseudotuberculosis infections, with a report of two cases. 77 44

Wound infection is the most common source of morbidity in appendicitis. Most recent pediatric series use protocols of preoperative antibiotics with aerobic and anaerobic coverage, intraoperative lavage, no peritoneal or wound drains, and continuation of antibiotics postoperatively with complicated appendicitis. There still remains controversy concerning skin closure and the duration of antibiotic therapy. We report the results of a prospective protocol followed over 2 years with 420 children. The protocol was designed to determine whether the skin could be closed primarily in all patients undergoing appendectomy. Preoperatively all patients received triple antibiotics (ampicillin, gentamicin, and clindamycin) that were continued postoperatively for two doses if there was a normal appendix or simple acute appendicitis, for at least 3 days with gangrenous appendicitis, and at least 5 days with perforated appendicitis. Antibiotics were continued if the patient remained febrile or had a white count greater than 10,000. No drains were used and the skin was closed primarily. The overall infectious complication rate was 1.0% (4/420). Among those with a normal appendix or simple acute appendicitis there were no infectious complications. Among those with gangrenous or perforated appendicitis there were 1.7% wound infections (2/117) and 1.7% intraabdominal abscesses (2/117). Duration of hospitalization was 2.1 days (range, 1 to 5 days) after simple acute appendicitis and 6.9 days (range, 3 to 40 days) after gangrenous or perforated appendicitis. These results set new standards in terms of wound management, infectious complications, and length of hospital stay.
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PMID:Appendicitis in children: current therapeutic recommendations. 227 22

Two hundred forty-six patients with acute appendicitis were randomly assigned to one of two groups. One group of 120 patients received systemic clindamycin preoperatively. Another group of 126 patients received, in addition to systemic clindamycin, a solution of topical ampicillin applied to subcutaneous tissues. No differences were found in the characteristics of the two groups. Combined prophylaxis with clindamycin and ampicillin significantly reduced wound infection to 4%, compared with clindamycin alone (p less than 0.02). A decrease in the surgical wound infection rate in the group treated with clindamycin and ampicillin was mainly observed in patients with advanced (gangrenous and perforated) appendicitis (p less than 0.05). A significant decrease in wound infection rates in patients with positive culture results was also found. We conclude that prophylaxis with a combination of systemic clindamycin and topical ampicillin solution, when compared with clindamycin alone, more effectively prevents wound infection after emergency appendectomy, especially in patients with serious wound contamination.
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PMID:Combined topical and systemic antibiotic prophylaxis in acute appendicitis. 230 17

One-hundred consecutive patients undergoing appendicectomy either electively or for clinically diagnosed acute appendicitis were studied to examine the difference between the use of topical povidone-iodine (PVP-I) and ampicillin in the wound given at the time of closure. All patients were treated with metronidazole suppositories for 48 h starting at the time of pre-medication in addition to a topical agent. The overall wound infection rate was 14%. If the appendix was histologically normal or inflamed, the rate fell to 10% whereas if gangrenous or perforated it rose to 24%. Sixty-six per cent of the patients with a perforated appendicitis developed a wound infection. There was no significant difference in the wound infection rate between those treated with PVP-I and those with ampicillin. Topical antisepsis using PVP-I is preferable to ampicillin as it abolishes the risk of antibiotic resistance or allergy developing and since it is comparatively more cost-effective.
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PMID:Systemic metronidazole combined with either topical povidone-iodine or ampicillin in acute appendicitis. 286 Jan 83

Sulbactam is a beta-lactamase inhibitor that, when combined with ampicillin, gives the latter antibiotic a broad spectrum of activity, making it suitable for use as a prophylactic agent in acute appendicitis. In a single-blind, randomized trial, the efficacy of sulbactam plus ampicillin was compared with that of metronidazole plus cefotaxime. Thirty-five children undergoing appendectomy received intravenous sulbactam and ampicillin, while 38 children received metronidazole and cefotaxime. Single doses were given unless the appendix was considered gangrenous or perforated, in which case the drugs were administered for 72 hr. There were three wound infections in the group given sulbactam and ampicillin and five in the group given metronidazole and cefotaxime. The combination of sulbactam and ampicillin was well tolerated and appeared to be at least as effective as that of metronidazole and cefotaxime in the prevention of sepsis following appendectomy.
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PMID:A randomized comparative study of sulbactam plus ampicillin vs. metronidazole plus cefotaxime in the management of acute appendicitis in children. 302 17

To determine the clinical significance of Kluyvera isolates at our institution, we retrospectively analyzed clinical microbiology data from January 1999 to September 2003. We identified 11 isolates classified as Kluyvera ascorbata, 7 of which were considered clinically significant pathogens: 3 cases represented urinary tract infections; 2, bacteremia; 1, a soft tissue infection of the finger; and 1, acute appendicitis with a subsequent intra-abdominal abscess. The age distribution of patients was wide, ranging from 2 months to 73 years. Antimicrobial susceptibility studies of the clinically significant and non-clinically significant Kluyvera isolates showed susceptibility patterns similar to those reported in the medical literature, namely trends of resistance to ampicillin and first- and second-generation cephalosporins. Of the 4 non-clinically significant isolates in our study, 1 was resistant to ciprofloxacin, a finding reported in only 1 other isolate of Kluyvera in the medical literature. Patient outcome after treatment with third-generation cephalosporins and aminoglycosides in the 7 clinically significant cases was good, with no long-term sequelae. The potential virulence of K ascorbata highlights the need for heightened scrutiny of its antimicrobial susceptibility patterns for adequate clinical treatment.
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PMID:Clinically significant Kluyvera infections: a report of seven cases. 1571 28

A total of 249 patients, undergoing appendectomy for acute appendicitis, were prospectively randomized into two groups. Group I, comprising 132 patients, received sterile normal saline irrigation to the surgical wound at closure. Alternatively, Group II included 117 patients, who received intraoperative topical ampicillin irrigation of the wound. Both groups were comparable with regard to age, sex, duration of symptoms, and severity of appendicitis. All patients additionally received preoperative systemic gentamicin and Flagyl. Wound infection occurred in 5.3% of Group I compared to only 0.9% of Group II (P<0.05). The reduction in infection rate was significant (P<0.05) in histologically proven appendicitis. We conclude that the addition of intraoperative topical ampicillin to systemic gentamicin and Flagyl augments prophylaxis against wound infection in acute appendicitis.
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PMID:Topical ampicillin for prophylaxis against wound infection in acute appendicitis. 1758 99

Antibiotic treatment for acute appendicitis is empirically chosen, based on epidemiological information. Resistance rates are different between regions and there are limited data on the situation in Argentina. As a part of a multicenter, observational study of abdominal infections, we performed the analysis of adult patients diagnosed with appendicitis, enrolled in 16 centers of 5 provinces, between Jan/01/2014 and Jun/30/2015. The aim was to analyze the prevalent aerobic pathogens, their resistance rates and the antimicrobial prescription pattern. On a total of 131 appendicitis cases analyzed, we found 184 aerobic pathogens (1.4 bacteria/episode): Escherichia coli 106 (57.6%), Klebsiella spp 16 (8.7%), Pseudomonas aeruginosa 19 (10.3%), Enterobacter spp. 2 (1%), other Gram negative bacilli 5 (2.7%); Enterococcus spp. 16 (8.7%) and other Gram positive cocci 20 (10.9%). The resistance rate of E. coli and enterobacteria to ampicillin/sulbactam was greater than 34% and greater than 31% to ciprofloxacin. However, the resistance of enterobacteria to piperacillin/tazobactam was 4.8%, to ceftriaxone 9.5%, to amikacin 3.6% and 8.2% to gentamicin. No resistance to carbapenems was found. The choice of quinolones or ampicillin/sulbactam for the treatment of appendicitis should be discouraged in our context, due to the high rates of resistance found in this prevalent etiology. Aminoglycoside-based treatments should be considered, given the findings of high antibiotic susceptibility and their low impact on the induction of resistance.
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PMID:[Aerobic etiology of acute appendicitis in adults. Multicenter study of abdominal sepsis in Argentina]. 2846 18


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