Antibiotic management for patients with confirmed perforation seen in operating room; and for medical management for patients with signs of walled off abscess on ultrasound or appendical mass.
CLSI (microbiology) guidelines do not recommend culturing as heavy growth of multiple organisms is likely, and does not appear to change the outcomes of the disease after surgical intervention. Clinical relevance of growth is uncertain.
J Pediatr Surg. 2010 Nov;45(11):2181-5. Antibiotics and appendicitis in the pediatric population: an American Pediatric Surgical Association Outcomes and Clinical Trials Committee systematic review.
Guidelines