Perioperative Antibiotics in Appendicitis—Do We Need to Adjust Therapy for the Elderly? A Matched Pair Analysis
Abstract
:1. Introduction
2. Results
2.1. Clinical Characteristics
2.2. Perioperative Patient Management
2.3. Microbiological Results
2.4. Antimicrobial Resistances
2.4.1. Aerobic Gram-Positive Bacteria
2.4.2. Aerobic Gram-Negative Bacteria
3. Discussion
4. Materials and Methods
4.1. Data Acquisition
4.2. Matching Process
4.3. Clinical Definitions
4.4. Isolation and Identification of Strains
4.5. Statistics
5. Conclusions
Abbreviations
ASA | American Society of Anesthesiologist |
CRP | C-reactive protein |
CT | Computed tomography |
EAES | European Association of Endoscopic Surgery |
EUCAST | European Society of Clinical Microbiology and Infectious Diseases |
IQR | Interquartile range |
SD | Standard deviation |
SSI | Surgical site infection |
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Young (n = 139) | Elderly (n = 139) | p | |
---|---|---|---|
Sex male (Percentage) | 68 (49%) | 68 (49%) | 1 |
Age (mean in years ± SD) | 38.4 (±13.6) | 69.8 (±7.5) | 0 |
Body mass index (mean in kg/m2 ± SD) | 25.9 (±5.6) | 27.1 (±5.2) | 0.019 |
American Society of Anesthesia-Score | |||
I | 77 (55.4%) | 13 (9.4%) | <0.001 |
II | 53 (38.1%) | 95 (68.3%) | |
III | 9 (6.5%) | 31 (22.3%) | |
Preoperative diagnosis | |||
Ultrasound | 126 (90.6%) | 102 (73.4%) | <0.001 |
Computed tomography | 49 (35.3%) | 96 (69.1%) | <0.001 |
Complicated Appendicitis | 106 (76.3%) | 106 (76.3%) | 1 |
C-reactive protein at presentation | 1 | ||
<2.5 mg/dL | 31 (22.3%) | 31 (22.3%) | |
2.5–5 mg/dL | 19 (13.7%) | 19 (13.7%) | |
5–7.5 mg/dL | 11 (7.9%) | 11 (7.9%) | |
7.5–10 mg/dL | 10 (7.2%) | 10 (7.2%) | |
>10 mg/dL | 68 (48.9%) | 68 (48.9%) | |
Operating time (median in min, range) | 57 (16–211) | 56 (18–186) | 0.71 |
Surgical strategy | 0.487 | ||
Open appendectomy | 6 (4.3%) | 3 (2.2%) | |
Laparoscopic appendectomy | 128 (92.1%) | 128 (92.1%) | |
Conversion to open appendectomy | 5 (3.6%) | 8 (5.8%) | |
Length of stay (median in days, range) | 2 (1–25) | 3 (1–15) | 0.159 |
Young (n = 139) | Elderly (n = 139) | p | |
---|---|---|---|
Intraoperative cultures drawn | 94 (67.6%) | 95 (68.3%) | 0.898 |
Intraoperative culture positivity | 73 (77.7%) | 77 (81.1%) | 0.564 |
Postoperative antibiotic continuation | 79 (56.8%) | 80 (57.6%) | 0.904 |
Duration of postoperative antibiotics (median in days, IQR) | 3 (2–4) | 3 (3–5) | 0.095 |
Antibiotic classes/substance | |||
Aminopenicillins | 2 (0.1%) | 1 (0.1%) | |
Piperacillin/tazobactam | 23 (16.5%) | 35 (25.2%) | |
2nd Generation cephalosporins | 2 (0.2%) | 3 (2.2%) | 0.387 |
3rd Generation cephalosporins | 25 (18.0%) | 19 (13.7%) | |
Fluoroquinolones | 26 (18.7%) | 22 (15.8%) | |
Carbapenems | 0 | 0 | |
± Metronidazole | 52 (37.4%) | 45 (32.4%) | 0.216 |
Surgical site infection | 17 (12.2%) | 11 (7.9%) | 0.232 |
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Strohäker, J.; Brüschke, M.; Leser, N.; Königsrainer, A.; Ladurner, R.; Bachmann, R. Perioperative Antibiotics in Appendicitis—Do We Need to Adjust Therapy for the Elderly? A Matched Pair Analysis. Antibiotics 2022, 11, 1525. https://doi.org/10.3390/antibiotics11111525
Strohäker J, Brüschke M, Leser N, Königsrainer A, Ladurner R, Bachmann R. Perioperative Antibiotics in Appendicitis—Do We Need to Adjust Therapy for the Elderly? A Matched Pair Analysis. Antibiotics. 2022; 11(11):1525. https://doi.org/10.3390/antibiotics11111525
Chicago/Turabian StyleStrohäker, Jens, Martin Brüschke, Nora Leser, Alfred Königsrainer, Ruth Ladurner, and Robert Bachmann. 2022. "Perioperative Antibiotics in Appendicitis—Do We Need to Adjust Therapy for the Elderly? A Matched Pair Analysis" Antibiotics 11, no. 11: 1525. https://doi.org/10.3390/antibiotics11111525
APA StyleStrohäker, J., Brüschke, M., Leser, N., Königsrainer, A., Ladurner, R., & Bachmann, R. (2022). Perioperative Antibiotics in Appendicitis—Do We Need to Adjust Therapy for the Elderly? A Matched Pair Analysis. Antibiotics, 11(11), 1525. https://doi.org/10.3390/antibiotics11111525