Once daily dosing of ceftriaxone and metronidazole in children with perforated appendicitis

Ji Yeon Lee, Saudia Ally, Brian Kelly, David Kays, Lisa Thames

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


OBJECTIVES: The aim of this study was to compare hospital length of stay and rate of infectious complications in children with perforated appendicitis based on the postoperative antibiotic administered. METHODS: This study was a retrospective analysis of children with perforated appendicitis who underwent an appendectomy at a large academic medical center from 2008 to 2013. The primary outcome was hospital length of stay. The secondary outcomes were rates of abscess formation, wound infection, and 30-day readmissions. RESULTS: One hundred and twenty-three patients were included. Sixty-six patients (53%) were administered ceftriaxone and metronidazole once daily; 57 (47%) were administered other antibiotic regimens, which consisted of single, double, or triple antibiotic therapy with a beta-lactam backbone. There was no difference between the groups in terms of postoperative length of stay (5.7 versus 5.8 days, p = 0.83), postoperative abscess rate (8% versus 4%, p = 0.57), postoperative wound infection rate (5% versus 2%, p = 0.73), and 30-day readmissions (3% versus 11%, p = 0.19). CONCLUSIONS: While there was no statistically significant difference in the outcomes evaluated, the rate of infectious complications was twofold higher in those given ceftriaxone and metronidazole than in others. A larger prospective randomized controlled trial is warranted to better understand the risks of using these agents.

Original languageEnglish (US)
Pages (from-to)140-145
Number of pages6
JournalJournal of Pediatric Pharmacology and Therapeutics
Issue number2
StatePublished - Mar 1 2018


  • Antibiotics
  • Appendectomy
  • Ceftriaxone
  • Metronidazole
  • Pediatrics
  • Perforated appendicitis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pharmacology (medical)


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