Perianal abscess in children: an evaluation of microbiological etiology and the effectiveness of antibiotics

Pediatr Surg Int. 2023 Sep 11;39(1):272. doi: 10.1007/s00383-023-05556-1.

Abstract

Purpose: We aimed to evaluate the demographic characteristics of children with perianal abscess, distribution of microbiological etiology, antibiotic susceptibility, and identify the effectiveness and coverage of antibiotics due to culture results.

Methods: A retrospective study was designed to evaluate pediatric patients with perianal abscesses between January 2013 and December 2022.

Results: A total of 197 episodes in 135 patients were evaluated. The median age of the patients was 10 months (22 days-17 years). The isolated microorganisms were Gram-positive bacteria in 56 (28.4%) patients and Gram-negative bacteria in 141 (71.6%) patients. The most common isolated species was Escherichia coli (n = 70, 35.5%), followed by Klebsiella spp. (n = 48, 24.4%), Staphylococcus aureus (n = 37, 18.9%), and Enterobacter spp. (n = 9, 4.5%). Forthy-two percent (n = 58) of isolates were positive for extended-spectrum beta-lactamase, 8% (n = 11) were carbapenem-resistant in Gram-negative bacteria, and 37.5% (n = 21) were methicillin-resistant, 7.1% (n = 4) were vancomycin-resistant in Gram-positive bacteria. According to bacterial culture results, ertapenem plus glycopeptide had the highest antimicrobial coverage rate (92.3%), followed by ertapenem plus clindamycin (89.8%), ertapenem (81.7%), third-generation cephalosporin plus glycopeptide (82.2%), third-generation cephalosporin plus clindamycin (69.5%).

Conclusion: Ertapenem can be a good choice in the empirical treatment of perianal abscesses in children due to its high coverage rate.

Keywords: Abscess; Antibiotic; Ertapenem; Pediatric; Perianal.

MeSH terms

  • Abscess* / drug therapy
  • Abscess* / microbiology
  • Adolescent
  • Anti-Bacterial Agents* / therapeutic use
  • Anus Diseases
  • Child
  • Child, Preschool
  • Female
  • Gram-Positive Bacteria* / drug effects
  • Gram-Positive Bacterial Infections* / drug therapy
  • Humans
  • Infant
  • Male
  • Retrospective Studies

Substances

  • Anti-Bacterial Agents