YOU ARE NOW CONNECTED TO THE TOXLINE (1981 FORWARD, NON-ROYALTY) FILE. ==APPENDIX, RUPTURED== 1 AUTHOR Schropp KP AUTHOR Kaplan S AUTHOR Golladay ES AUTHOR King DR AUTHOR Pokorny W AUTHOR Mollitt DL AUTHOR Wise WE Jr AUTHOR Mason EO TITLE A randomized clinical trial of ampicillin, gentamicin and clindamycin versus cefotaxime and clindamycin in children with ruptured appendicitis. SOURCE Surg Gynecol Obstet; VOL 172, ISS 5, 1991, P351-6 ABSTRACT This prospective, randomized, double-blind study compares the efficacy, safety and cost-effectiveness of ampicillin, gentamicin and clindamycin (AGC) or cefotaxime and clindamycin (CC) for the treatment of children with complicated appendicitis. Ninety-seven children were randomized. Forty-seven were assigned to the AGC regimen and 50 received CC. Forty-two patients in the AGC group had an appropriate therapeutic outcome, whereas 48 of 50 children who received CC completed the trial successfully (p = NS). There were no differences between the groups with reference to the duration of antibiotic administration, fever, leukocytosis or length of hospitalization. Complications of therapy were uncommon and neither regimen demonstrated a significant advantage from an economic standpoint. We concluded that, in childhood, complicated appendicitis can be treated with either CC or AGC with equal efficacy. 2 AUTHOR Pokorny WJ AUTHOR Kaplan SL AUTHOR Mason EO Jr TITLE A preliminary report of ticarcillin and clavulanate versus triple antibiotic therapy in children with ruptured appendicitis. SOURCE Surg Gynecol Obstet; VOL 172 Suppl, 1991, P54-6 ABSTRACT Standard therapy for childhood ruptured appendicitis includes combination antibiotic therapy with ampicillin, gentamicin and clindamycin. Complicated dosing schedules and the possibility of aminoglycoside toxicity make alternatives desirable. One such alternative is Timentin (a combination agent of ticarcillin disodium and clavulanate potassium). This agent has a more convenient dose schedule than standard therapy and eliminates the possibility of aminoglycoside ototoxicity and nephrotoxicity. It is active in vitro against most pathogens associated with ruptured appendicitis in children. The preliminary results of an ongoing prospective, open label, randomized trial comparing ticarcillin and clavulanate with ampicillin, gentamicin and clindamycin in childhood ruptured appendicitis are reported herein. While further evaluation is necessary, we have found single agent therapy with ticarcillin and clavulanate to be equivalent in safety and efficacy to standard combination therapy. Also discussed are the relative merits of immediate versus delayed primary closure of the abdominal wound after appendectomy. 4 TITLE A Danish multicenter study: cefoxitin versus ampicillin + metronidazole in perforated appendicitis. SOURCE Br J Surg; VOL 71, ISS 2, 1984, P144-6 ABSTRACT A prospective controlled randomized-block multicenter study was carried out in 209 patients undergoing surgery for perforated or ruptured appendicitis. The patients received either cefoxitin or ampicillin + metronidazole for 5 days. The treatment was started peroperatively. In both groups wound infections were found to be less than 10 per cent and no difference could be demonstrated. However cefoxitin was significantly superior to ampicillin + metronidazole in preventing intra-abdominal abscesses (P less than 0.05). Cefoxitin offers a single drug treatment that adequately reduces postoperative infectious complications in patients undergoing surgery for perforated or ruptured appendicitis.