Appendix D All Patients with Appendicitis COMPLICATED UNCOMPLICATED ALL other patients with appendicitis 1. Continued on Ceftriaxone/Flagyl 2. Dose timing as an extension of preoperative dose(s) of those antibiotics 1. Viable appendix 2. No evidence of gangrene 3. No evidence of perforation 4. Fluid can be clear or cloudy but not thick or with fibrinous exudate Discharge Criteria 1. Afebrile (febrile =temp>38.5) 2. Normal heart rate for age (PALS) 3. Normal blood pressure for age (PALS) 4. Surgical site(s) are clean, dry, and intact 5. Pain well controlled with IV or oral pain medication 6. Tolerating PO well (PO fluids > IV maintenance rate 7. Pain controlled with oral pain medication (pain score ≤ 3) 8. Patient is ambulating well 9. Parents are ready for the patient to go home 10. The patient has no supplemental oxygen requirement 11. Foley is out and able to urinate 12. No nausea or vomiting When all criteria are met Patient Tracker sends a page to NP/Resident indicating patient has met discharge criteria Discharge Criteria Same as uncomplicated appendicitis except patient must be afebrile for 24 hours No CT abdomen/pelvis until POD 10 No PICC/TPN until POD 5 No change in antibiotics without a culture demonstrating resistance or ID consult When all criteria are met Patient Tracker sends a page to NP/Resident indicating patient has met discharge criteria NORMAL WBC Stop Antibiotics Home Follow-up in 1 week Obtain pre-clinic CBC Home Follow-up in 2-3 weeks Home Follow-up in 1 week Obtain pre-clinic CBC Check WBC Either absolute WBC for age or differential ABNORMAL WBC Switch to Oral Antibiotics Cefdinir 14 mg/kg PO 1X/day ≥ 13 years of age 7 mg/kg PO 2X/day for 6months to 12 years of age Flagyl 10mg/kg PO 3X /day ≥ 13 years of age 7.5 mg/kg PO 4X/day for 6 months to 12 years of age Duration to cover until first clinic visit