WBC: white blood cell count; US: ultrasound; IV: intravenous.
* Nonoperative management should only be performed by a surgeon with pediatric expertise.
¶ Antibiotic choices are not standardized. Refer to Table 2 for sample choices. Refer to UpToDate content on the management of appendicitis in children for other appropriate antibiotic regimens.
Δ Lower rates of initial failure or recurrence are associated with using strict criteria for nonoperative management.
◊ These are sample choices for low- to moderate-risk community-acquired infections. For the full complement of suitable regimens, refer to the appropriate UpToDate content on management of appendicitis. Doses shown are for patients with normal kidney function; some agents require adjustment for kidney impairment; refer to Lexicomp drug monograph(s).
§ Amoxicillin-clavulanate is a reasonable option if the community rate of Escherichia coli resistance to the agent is <10%.