Surgical infections最新文献

{"title":"Assessment of Therapeutic Approaches: Necrotizing Soft Tissue Infections and the Choice Between Vancomycin + Clindamycin and Linezolid.","authors":"Joanna Nixon, Sara E Parli, Jacqueline M Bishop, Katie B Olney, Jeremy VanHoose, Alexandra Wiegand, Dina Ali, Courtney Bradley, Zachary D Warriner, Abigail Leonhard, Aric Schadler, William J Olney","doi":"10.1089/sur.2024.281","DOIUrl":"10.1089/sur.2024.281","url":null,"abstract":"<p><p><b><i>Background:</i></b> Necrotizing skin and soft tissue infections (NSTIs) are life threatening, requiring antibiotic agents and surgical intervention. Clindamycin or linezolid is recommended as an adjunct therapy for toxin mediation; however, limited data are comparing clindamycin-based to linezolid-based regimens in NSTI. <b><i>Methods:</i></b> This single-center retrospective study included adults with NSTI admitted to the intensive care unit (ICU) at the University of Kentucky HealthCare for surgical debridement between January 2017 and June 2023. Patients were excluded if they received antibiotic agents for <24 hours, underwent surgical debridement at an outside hospital, or were readmitted within the study period. The primary outcome was the number of debridements before source control. Secondary outcomes included time to source control, acute kidney injury (AKI) rates, ICU length of stay, and antibiotic duration. <b><i>Results:</i></b> A total of 242 patients were included with 199 receiving clindamycin and 43 receiving linezolid. There was no difference observed in the number of surgical debridements between the clindamycin and linezolid cohorts ([2.0 (2, 4) vs. 3.0 (2, 4)]; p = 0.219). The multi-variable regression identified independent parameters that predicted a significant increase in number of debridements included sequential organ failure assessment score (1.03 [1.003, 1.047]; p = 0.028), culture(s) positive for <i>Streptococcus anginosus, Streptococcus constellatus</i>, or <i>Streptococcus intermedius</i> (1.309 [1.042, 1.629]; p = 0.018), and <i>Bacteroides</i> spp. (1.301 [1.048, 1.602]; p = 0.015). No differences were observed in AKI ([53.8% vs. 60.8%], p = 0.424), ICU stay ([5.3 vs. 6.1 d]; p = 0.399), or antibiotic duration between vancomycin, clindamycin, and linezolid ([5.6 vs. 5.6 vs. 6.7 d]; p = 0.683), respectively. <b><i>Conclusions:</i></b> Linezolid resulted in a similar number of surgical debridements compared with clindamycin in NSTI patients.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"467-473"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors of Post-Craniotomy Surgical Site Infection: A Retrospective Study.","authors":"Entisar M Alotaibi, Tala Abedalqader, Abderrahman Ouban, Abdulaziz Barakat, Atef M Shibl","doi":"10.1089/sur.2024.177","DOIUrl":"10.1089/sur.2024.177","url":null,"abstract":"<p><p><b><i>Background:</i></b> Although surgical site infection following craniotomy (SSI-CRAN) is uncommon, it is a significant complication of surgical procedures. In addition, it imposes a considerable disease burden on patients and healthcare systems regarding morbidity, mortality, and economic costs. Despite that, the risk factors for its development are unknown. Therefore, identifying the risk factors for SSI-CRAN enables the determination and implementation of preventative measures to lower the infection rate. <b><i>Methods:</i></b> This retrospective cohort research was conducted on patients who underwent craniotomy operation for any indication from January 01, 2011 to December 31, 2020 in the neuroscience center at King Fahad Medical City (Riyadh, Saudi Arabia) to determine risk factors for SSIs. Many patient-related and procedure-related factors were tested as possible risk factors for craniotomy SSI. <b><i>Results:</i></b> This 9-year retrospective study found an overall SSI-CRAN rate of 3.02%. Gram-negative bacteria were the predominant causative pathogen (75.35%). Cerebrospinal fluid leak (odds ratio [OR]: 18, 95% confidence interval [CI]: 9.50-34.0), seizure (OR: 30.50, 95% CI: 16.3-57.2), history of hypertension (OR: 14.9, 95% CI: 8.2-27.1), bronchial asthma (OR: 3.80, 95% CI: 1.5-9.5), and history of epilepsy (OR: 7.20, 95% CI: 3.0-17.40) were associated with an increased risk of post-operative SSIs in the multivariable regression analysis model. No significant associations with gender, age, American Society of Anesthesiologists class, body mass index, use of pre- or post-operative antibiotic agents, duration of surgical procedure, number of operations, length of stay, or risk index have been found. <b><i>Conclusion:</i></b> The risk parameters and causal agents for SSI-CRAN found in this study should be considered when developing preventative strategies to reduce this devastating complication's incidence. Identifying risk factors for SSI should aid in improving patient treatment and declining mortality, morbidity, and the economic burden associated with healthcare costs. Post-operative surveillance is also critical for identifying reliable risk parameters for SSI.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"461-466"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lactate Levels and Their Relation to Surgical Site Infections in Patients Undergoing Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy.","authors":"İsa Caner Aydın, Ahmet Orhan Sunar, Serkan Ademoğlu, Ömer Özduman, Uğur Duman, Selçuk Gülmez, Mustafa Duman, Erdal Polat","doi":"10.1089/sur.2025.006","DOIUrl":"10.1089/sur.2025.006","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Peritoneal carcinomatosis (PC) patients undergoing cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) face a high risk of morbidity. Surgical site infections (SSIs) are among the main contributors to this issue. This relation is influenced not only by the effects of major surgical resections but also by the hemodynamic changes induced by HIPEC. Although elevated lactate levels (LL) have been associated with greater complication rates in CRS-HIPEC patients, their direct association with the development of SSIs has not been thoroughly investigated. <b><i>Methods:</i></b> Patients who underwent CRS + HIPEC were retrospectively reviewed. Pre-operative demographic data, hemodynamic parameters and records, transfusion records, and all post-operative follow-up and treatment records were analyzed. Patients were categorized into SSI+ and SSI-. Factors contributing to SSI development were examined using regression analysis. <b><i>Results:</i></b> A total of 110 patients who underwent CRS + HIPEC between January 2018 and December 2021 were included in the study. LL obtained at intensive care unit (ICU) admission were greater in patients who developed SSIs (p = 0.020). Cutoff point for ICU admission LL in diagnosing SSI was ≥6 mmol/L (area under the curve: 0.640 [0.526-0.753], p = 0.020). SSI development (23% vs. 50%, p = 0.003) was more prevalent in patients with lactate values ≥6 mmol/L. In multi-variable analysis, LL ≥6 mmol/L (odds ratio [OR]: 4.614, p = 0.005) and clean-contaminated wounds (OR: 27.677, p = 0.002) were related with increased SSI development. <b><i>Conclusion:</i></b> In patients with PC, LL of 6 mmol/L or greater during the ICU stay have been associated with SSI development. For this high-risk patient subgroup, a readily available peri-operative parameter such as lactate may guide prophylactic antibiotic selection. However, despite its high specificity, the low sensitivity of our findings should be carefully considered before clinical decision-making. Further studies analyzing larger, more homogeneous cohorts are needed to better clarify the relation between LL, SSI development, and prophylactic antibiotic use.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"501-513"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Recurrent Episodes of Suspected Pneumonia.","authors":"Tateum L Mattingly, Jordan Baker, Isuru Ratnayake, Jacob C O'Dell, Robel T Beyene, Christopher M Watson, Robert G Sawyer, Steven Q Simpson, Leanne Atchison, Michael Derickson, Lindsey C Cooper, G Patton Pennington, Sheri VandenBerg, Bachar N Halimeh, Christopher A Guidry","doi":"10.1089/sur.2024.287","DOIUrl":"10.1089/sur.2024.287","url":null,"abstract":"<p><p><b><i>Background:</i></b> Pneumonia remains the most common intensive care unit (ICU)-acquired infection with patients often suffering multiple episodes. The diagnosis remains difficult as many non-infectious causes can masquerade as pneumonia. The purpose of this study is to identify risk factors for potential recurrent pneumonia from a recent randomized trial. <b><i>Methods:</i></b> We performed a retrospective analysis of the recent Trial of Antibiotic Restraint in Presumed Pneumonia (TARPP), which was a multicenter trial of antibiotic initiation strategies. Demographics, comorbidities, and outcomes were reviewed. Standard uni-variable statistical analysis was performed. <b><i>Results:</i></b> TARPP enrolled 186 patients with 47 patients (25.3%) having at least one additional episode of suspected pneumonia. Patients with recurrent episodes of suspected pneumonia were more likely to identify as Hispanic or Latino or to speak Spanish as their primary language. Patients with recurrent suspected episodes had longer ICU length of stay, total days of antibiotic agents, and longer ventilator days. Patients with recurrent episodes had a greater overall of culture positivity, but no difference in the rate of infection because of non-fermenting gram-negatives. Patients with recurrent episodes had lower mortality rates overall compared with those with a single infectious episode. <b><i>Conclusions:</i></b> This retrospective analysis suggests that ethnicity and language barriers may be associated with recurrent suspected pneumonia. Although greater rate of culture positivity was associated potential recurrence, the lower mortality rates in this group suggest a survivorship bias. More work is needed to evaluate the risks for recurrent pneumonia in the ICU.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"514-519"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Early and Late Muscle Flap Salvage of Complicated Lower Extremity Vascular Grafts.","authors":"Mariam Saad, Andrew James, Helen Ismail, Mae Wimbiscus, Ziad Al Adas, William C Lineaweaver","doi":"10.1089/sur.2024.186","DOIUrl":"10.1089/sur.2024.186","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Muscle flaps are commonly used to protect high-risk vascular grafts in the lower extremities. This study aimed to identify differences between early and late salvage procedures. <b><i>Methods:</i></b> Patients undergoing lower extremity vascular reconstruction with muscle flap coverage at a tertiary medical center from 2017 to 2023 were identified. Data included demographics, procedure details, and complications. The study compared early (placed at index or ≤7 d after vascular surgical procedure) versus delayed (>7 d) flap inset. Primary outcomes included rates of infection, hematoma, seroma, necrosis, wound dehiscence, flap failure, and patency of the vascular repair. Secondary outcomes included culture results from the surgical site. <b><i>Results:</i></b> Eighty-one patients met inclusion criteria. Early flaps were inset in 53% of cases, and 47% were delayed. Sartorius flaps were most common (53%), followed by gracilis flaps (37%). The indication for flap coverage significantly varied between immediate and delayed flaps (p = 0.004), with immediate more commonly placed for tissue coverage (37%) and delayed inset to address infection (68%). Flap survival (86.1% vs. 76.3%, p = 0.261) and graft patency (74.4% vs. 68.4%, p = 0.55) were similar between groups. Rates of infection, seroma, hematoma, and wound dehiscence did not differ significantly. Regression analysis did not find associated factors with complication incidence. <i>Enterobacter</i> infections were more common in the delayed group (15.8% vs. 2.3%, p = 0.031). <b><i>Conclusion:</i></b> This study showed no difference in outcomes between immediate and delayed muscle flaps placed over vascular grafts. Delayed procedures show a greater prevalence of certain bacteria in delayed flaps.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"482-488"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Management of Pseudomeningocele Combined with Intracranial Infections Following Neurosurgical Operation.","authors":"Wei-Long Ding, Jing Wang, Jun-Bao Yang, Shi-Jie Guo, Xiang-Yu Wang","doi":"10.1089/sur.2024.289","DOIUrl":"10.1089/sur.2024.289","url":null,"abstract":"<p><p><b><i>Background:</i></b> Pseudomeningocele is a common post-operative complication after a neurosurgical operation. Infection combined with pseudomeningocele can induce substantial morbidity. We presented a series of cases with pseudomeningocele combined with intracranial infection following neurosurgical operation focusing on operative technique and long-term clinical outcome. This study aimed to determine the efficacy of the novel surgical technique in tackling the intractable post-operative complication. <b><i>Methods:</i></b> A retrospective analysis of patients with pseudomeningocele and intracranial infection following neurosurgical operations between 2012 and 2024 was performed. Standard statistical methods helped explore the associations between parameters requiring reoperation. The authors described surgical techniques and treatment strategies for pseudomeningocele combined with intracranial infection after a neurosurgical operation. <b><i>Results:</i></b> Of the 58 patients, 17 (29.3%) presented with post-operative pseudomeningocele, which was refractory to conservative treatment along with intracranial infection requiring surgical management. Pseudomeningocele requiring reoperation was much more likely in patients with craniectomy and those with craniotomy (41.9% vs. 14.8%, p = 0.024). Moreover, pseudomeningocele was more likely in patients without watertight closures than with (52.2% vs. 14.3%, p = 0.002). The post-operative image indicated no recurrence in these patients who underwent reoperation. <b><i>Conclusions:</i></b> The novel operative technique could successfully treat pseudomeningocele combined with intracranial infection refractory after a neurosurgical operation.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"489-495"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Highlights from the 37th Annual Meeting of the Japanese Society of Surgical Infection.","authors":"Robert G Sawyer, Sean M A Sawyer","doi":"10.1089/sur.2025.045","DOIUrl":"10.1089/sur.2025.045","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"538-540"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Evaluation of Machine Learning Models for the Identification of Surgical Site Infection in Electronic Health Records.","authors":"Arjun Chakraborty, Kevin Lybarger, Jorge A Olivas Estebane, Judy Y Chen, Mahul Patel, Vikas O'Reilly-Shah, Peter Tarczy-Hornoch, Meliha Yetisgen, Dustin R Long","doi":"10.1089/sur.2024.266","DOIUrl":"10.1089/sur.2024.266","url":null,"abstract":"<p><p><b><i>Background:</i></b> Surgical site infection (SSI) affects 160,000-300,000 patients per year in the United States, adversely impacting a wide range of patient- and health-system outcomes. Surveillance programs for SSI are essential to quality improvement and public health systems. However, the scope of SSI surveillance is currently limited by the resource-intensive nature of these activities, which are largely based on manual chart review. Recent advances in natural language processing and machine learning could potentially augment the scope and quality of routine SSI surveillance. <b><i>Patients and Methods:</i></b> Electronic health records (EHRs) for 28,864 surgical procedures (representing 25% of all surgical cases) linked to either National Healthcare Safety Network (NHSN) data from Harborview Medical Center or National Surgical Quality Improvement Program (NSQIP) data from the University of Washington Montlake Medical Center were included. Cases comprised five different surgical procedure types performed between 2010 and 2020 (general surgery, gynecological surgery, spine surgery, non-spine orthopedic surgery, and non-spine neurological surgery). Using all clinical notes and structured data elements, we trained random forest and neural network models to identify SSI cases. We conducted experiments to evaluate the impact of clinical notes on the task of retrospective SSI identification and to study domain adaptation across different procedure types and registries. <b><i>Results:</i></b> The best performing model utilized a neural network with input derived from both structured data and unstructured text notes, trained on all surgery types (F1 score: NHSN 0.77, NSQIP 0.58; area under the receiver operating characteristic curve: NHSN 0.98, NSQIP 0.92; recall: NHSN 0.85, NSQIP 0.61). Jointly training one model on all domains (both registries, all surgery types) yielded better performance than training procedure- or registry-specific models. <b><i>Conclusion:</i></b> Automated systems for retrospective identification of SSI in EHRs have the potential to improve the efficiency and reliability of chart reviews for national surveillance and quality improvement programs.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"474-481"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Choice of Machine Learning Models Is Important to Predict Post-Operative Infections in Surgical Patients.","authors":"Addison Heffernan, Reetam Ganguli, Isaac Sears, Andrew H Stephen, Daithi S Heffernan","doi":"10.1089/sur.2024.288","DOIUrl":"10.1089/sur.2024.288","url":null,"abstract":"<p><p><b><i>Background:</i></b> Surgical quality datasets are critical to decision-making tools including surgical infection (SI). Machine learning models (MLMs), a branch of artificial intelligence (AI), are increasingly being ingrained within surgical decision-making algorithms. However, given the unique and distinct functioning of individual models, not all models may be suitable for acutely ill surgical patients. <b><i>Patients and Methods:</i></b> This is a 5-year retrospective review of National Surgical Quality Improvement Program (NSQIP) patients who underwent an operation. The data were reviewed for demographics, medical comorbidities, rates, and sites of infection. To generate the MLMs, data were imported into <i>Python</i>, and four common MLMs, extreme gradient boosting, K-nearest neighbor (KNN), random forest, and logistic regression, as well as two novel models (flexible discriminant analysis and generalized additive model) and ensemble modeling, were generated to predict post-operative SIs. Outputs included area under the receiver-operating characteristic curve (AUC ROC) including recall curves. <b><i>Results:</i></b> Overall, 624,625 urgent and emergent NSQIP patients were included. The overall infection rate was 8.6%. Patients who sustained a post-operative infection were older, more likely geriatric, male, diabetic, had chronic obstructive pulmonary disease, were smokers, and were less likely White race. With respect to MLMs, all four MLMs had reasonable accuracy. However, a hierarchy of MLMs was noted with predictive abilities (XGB AUC = 0.85 and logistic regression = 0.82), wherein KNN has the lowest performance (AUC = 0.62). With respect to the ability to detect an infection, precision recall of XGB performed well (AUC = 0.73), whereas KNN performed poorly (AUC = 0.16). <b><i>Conclusions:</i></b> MLMs are not created nor function similarly. We identified differences with MLMs to predict post-operative infections in surgical patients. Before MLMs are incorporated into surgical decision making, it is critical that surgeons are at the fore of understanding the role and functioning of MLMs.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"520-529"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triple Versus Double Antibiotic Therapy in Children Undergoing Laparoscopic Appendicectomy for Complicated Appendicitis: A Case-Control Study.","authors":"Kai-Zheong Lim, Ramesh M Nataraja, Maurizio Pacilli","doi":"10.1089/sur.2024.322","DOIUrl":"10.1089/sur.2024.322","url":null,"abstract":"<p><p><b><i>Background and Objectives:</i></b> Historically, a triple-antibiotic (TA) regimen (ampicillin, gentamicin, metronidazole) has been used for children with complicated appendicitis (CA) at our institution. We implemented a double-antibiotic (DA) regimen (ceftriaxone, metronidazole) in November 2018. The aim of this study was to compare the post-operative outcomes between the two groups. <b><i>Patients and Methods:</i></b> Clinical and laboratory data were collected from the medical records of children who underwent laparoscopic appendicectomy (LA) for CA between November 2017 and 2019. Data, reported as number of cases (%) and median with interquartile range or 95% confidence interval (CI), were analyzed with Fisher exact test and Mann-Whitney U test; p values <0.05 were considered significant. <b><i>Results:</i></b> One hundred and ninety-seven patients were identified; 99 treated with the TA regimen and 98 with the DA regimen. The groups had similar demographics. Post-operative complications were similar between the two groups: intra-abdominal abscess (IAA) 12 (12.1%) in TA versus 10 (10.2%) in DA (p = 0.82); surgical site infections 1 (1.0%) in TA versus 2 (2.2%) in DA (p = 0.62). Time to defervescence in the first 5 post-operative days was substantially longer in the TA group: 72 (95% CI 72-96) versus 48 (95% CI 48-72) hours (p = 0.003). Among patients without post-operative IAA, the DA group had a shorter post-operative hospital stay (5 [5-6] vs. 5.5 [5-6] days; p = 0.04). The cost of DA regimen was substantially lower (p < 0.0001). <b><i>Conclusions:</i></b> The DA regimen provided better post-operative temperature control and a quicker overall recovery, without increasing the incidence of IAA and surgical site infection in children following LA for CA.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"496-500"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}