A. David1, C. Dodgion1, S. Bou Zein Eddine1, D. Davila1, T. Webb1, C. Trevino1, C. Trevino1 1Medical College Of Wisconsin,Milwaukee, WI, USA
Introduction:
Shorter duration of antibiotics (3-5 days) has been shown to be equally effective as long duration (7-10 days) in treating intra-abdominal contamination. In September 2015, our practice pattern for antibiotic duration for perforated appendicitis patients was changed to reflect this finding. We hypothesized that a short duration of antibiotics is non-inferior to traditional long duration.
Methods:
We retrospectively reviewed all patients >18 yo who underwent operative management for perforated appendicitis between August 2011 and December 2017. We compared antibiotic duration, length of stay (LOS), infectious complications, and 30-day readmission rates before and after our practice change using chi square, fisher’s exact test and two sample t tests.
Results:
109 patients (58 before, 51 after) underwent an operation for perforated appendicitis. The mean duration of antibiotics was significantly less after September 2015 (before 5.5 days SD=2.9 vs after 4.1 days SD=1.7, p=0.005). The mean LOS (before 6.25 days SD=4.7 vs after 5.96 days SD=7.9, p=0.8) and hospital infectious complications (p=0.788) and rate of post-operative drain placement were not significantly different (p=0.32). There were significantly less readmissions after decreasing antibiotic duration (p=0.017). Those with drains placed pre-2015 had more readmissions, longer duration of antibiotics, but no difference in hospital complications or LOS.
Conclusion:
Decreasing antibiotic duration to 4 days did not increase our hospital infectious complications or readmission rates. Our data suggests that shorter duration of antibiotics is non-inferior to a longer course.