Comparative Approaches of Antibiotic Therapy and Surgical Intervention in Managing Recurrent Perirectal Abscess in Children Under Two Years Old.

BACKGROUND

Recurrent perirectal abscesses in children under 2 years pose management challenges due to high relapse risks, with limited evidence comparing long-term outcomes of antibiotic therapy versus surgical drainage. This study aimed to compare antibiotic treatment approaches and surgical interventions in managing this condition.

METHODS

This retrospective cohort study analyzed 336 medical records of children under two years old with perianal abscesses treated at Hazrat Masoumeh Children's Hospital from 2012-2019. Patients were divided into three groups: antibiotic treatment only, spontaneous drainage, and incision and drainage. Data, including demographics, abscess characteristics, and treatment outcomes (recurrence, fistula formation), were analyzed using SPSS software version 26.

RESULTS

A retrospective cohort study of 336 children with perianal abscesses found no significant differences in age, weight, sex, or nutritional status among the three treatment groups (P>0.05). However, statistically significant differences were observed in abscess location (distance from the anus) and size, with the incision and drainage group having larger and more distally located abscesses (P<0.05). Colic was less prevalent in the antibiotic-only group. The spontaneous drainage group had a significantly higher recurrence rate (37%). Antibiotic type distribution was similar across groups. The antibiotic-only group showed symptom resolution within 3-10 days, averaging 6 days.

CONCLUSION

In general, according to the lowest rate of recurrence in the group receiving antibiotics and the average duration of short treatment of 6 days, the antibiotic approach is the preferred and primary method for the treatment and prevention of abscess recurrence.