Comparison of the efficacy of carbapenems and cephalosporins for postoperative treatment of perforated appendicitis in children

Table 1 Preoperative baseline data characteristics of the two groups of patients, mean ± SD

Characteristics	CBP	CPS	T value or χ2	P value
Number of patients (n)	32	33	-	-
Gender (n, male:female)	23:9	20:13	0.921	0.337
Age (year)	6.94 ± 3.48	6.86 ± 3.20	0.095	0.924
Weight (kg)	29.63 ± 15.64	24.26 ± 9.21	1.694	0.095
Height (m)	1.21 ± 0.23	1.25 ± 0.23	0.747	0.457
BMI (n)	18.48 ± 2.72	17.33 ± 2.77	1.829	0.071
Ear temperature (℃)1	37.92 ± 0.73	37.60 ± 0.716	1.735	0.088
Heart rate (bpm)	113.03 ± 16.53	111.12 ± 15.32	0.483	0.630

¹Temperature measured on admission.

CBP: Carbapenem; CPS: Cephalosporin; BMI: Body mass index.

Table 2 Antimicrobial resistance profiles of the two major strains of bacteria, n (%)

Antimicrobial resistance	Pathogenic bacterial species
	E. coli (n = 26)	P. aeruginosa (n = 16)	Combine (n = 11)	Others (n = 12)
Amikacin	1 (3.70)	0 (0.00)	0 (0.00)	0 (0.00)
Amoxicillin/clavulanic acid potassium	8 (30.77)	6 (37.50)	3 (27.27)	4 (33.33)
Aztreonam	4 (15.38)	0 (0.00)	0 (0.00)	1 (8.33)
Gentamicin	4 (15.38)	4 (25.00)	3 (27.27)	3 (25.00)
Ceftazidime	0 (0.00)	0 (0.00)	0 (0.00)	1 (8.33)
Cefuroxime	12 (46.15)	6 (37.50)	4 (36.36)	6 (50.00)
Cefazolin	15 (57.69)	9 (56.25)	5 (45.45)	9 (75.00)
SMZ-TMP	11 (42.31)	8 (50.00)	5 (45.45)	6 (50.00)
Piperacillin tazobactam	0 (0.00)	0 (0.00)	0 (0.00)	0 (0.00)
Meropenem	0 (0.00)	0 (0.00)	0 (0.00)	0 (0.00)
Imipenem	0 (0.00)	0 (0.00)	0 (0.00)	0 (0.00)
Levofloxacin	3 (11.54)	2 (12.50)	2 (18.18)	0 (0.00)

E. coli: Escherichia coli; P. aeruginosa: Pseudomonas aeruginosa.

Table 3 Comparison of the effect of antibiotics on the postoperative recovery of children in two groups, n (%)

Project	CBP	CPS	Z value or χ2	P value
CRP recovery time (days)	8.12 ± 3.48	6.18 ± 1.84	2.59	0.009
GF recovery time (hours)	38.84 ± 23.37	35.08 ± 20.92	0.61	0.542
Hospital stay length (days)	8.63 ± 3.01	8.97 ± 2.80	0.94	0.344
Complications			3.41	0.065
No	25 (78.12)	31 (93.94)
Yes	7 (21.88)	2 (6.06)
Bowel obstruction			1.13	0.287
No	29 (90.62)	32 (96.97)
Yes	3 (9.38)	1 (3.03)
Ascites			3.24	0.072
No	29 (90.62)	33 (100.00)
Yes	3 (9.38)	0 (0.00)
Abdominal abscess			1.05	0.306
No	31(96.87)	33 (100.00)
Yes	1 (3.13)	0 (0.00)
Wound infections			0.98	0.321
No	32 (100.00)	32 (96.97)
Yes	0 (0.00)	1 (3.03)

CRP: C-reactive protein; GF: Gastrointestinal function; CBP: Carbapenem; CPS: Cephalosporin.

Table 4 Univariate analysis of binary logistic regression model for baseline characteristics and C-reactive protein recovery rate within 7 days postoperatively, n (%)

Project	n = 65	OR	95%CI	P value
Gender
Female	22 (33.85)	1.00	Refer
Male	43 (66.15)	1.10	0.35-3.46	0.878
Age (year)
≤ 5	24 (36.92)	1.00	Refer
> 5	41 (63.08)	0.56	0.19-1.68	0.300
Ear temperature (℃)
< 37.3	20 (30.77)	1.00	Refer
≥ 37.3	45 (69.23)	0.61	0.19-1.99	0.415
Antibiotic selection
CBP	32 (49.23)	1.00	Refer
CPS	35 (53.85)	3.92	1.32-11.62	0.014
Complications
No	56 (86.15)	1.00	Refer	-
Yes	9 (13.85)	0.82	0.18-3.71	0.797

CBP: Carbapenem; CPS: Cephalosporin.

Table 5 Univariate analysis of binary logistic regression model for baseline characteristics and gastrointestinal function recovery rate within 48 hours postoperatively, n (%)

Project	n = 65	OR	95%CI	P value
Gender
Female	22 (33.85)	1.00	Refer
Male	43 (66.15)	1.61	0.48-5.46	0.441
Age (year)
≤ 5	24 (36.92)	1.00	Refer
> 5	41 (63.08)	1.16	0.36-3.72	0.803
Ear temperature (℃)
< 37.3	20 (30.77)	1.00	Refer
≥ 37.3	45 (69.23)	0.32	0.08-1.35	0.122
Antibiotic selection
CBP	32 (49.23)	1.00	Refer
CPS	35 (53.85)	2.69	0.82-8.81	0.103
Complications
No	56 (86.15)	1.00	Refer	-
Yes	9 (13.85)	0.819	0.17-4.01	0.806

CBP: Carbapenem; CPS: Cephalosporin.

Table 6 Multivariate analysis of multinomial logistic regression model for perioperative characteristics and C-reactive protein recovery rate within 7 days postoperatively, n (%)

Project	n = 65	OR	95%CI	P value
Antibiotic selection
CBP	32 (49.23)	1.00	Refer
CPS	35 (53.85)	3.49	1.19-10.24	0.023
Pathogenic bacteria species
E. coli	26 (40.00)	1.00	Refer
P. aeruginosa	16 (24.62)	0.84	0.20-3.56	0.818
Combine	11 (16.92)	0.76	0.15-3.89	0.739
Others	12 (20.00)	0.79	0.14-4.37	0.785

CBP: Carbapenem; CPS: Cephalosporin; E. coli: Escherichia coli; P. aeruginosa: Pseudomonas aeruginosa.