Zhang Y, et al. - Researchers investigated the therapeutic efficacy and cost-effectiveness of antibiotics alone vs antibiotics plus percutaneous drainage (PD) in order to ascertain the optimal nonoperative management of periappendiceal abscess in a pediatric population. A 10-year retrospective chart review was performed among pediatric patients less than 18 years of age who had acute perforated appendicitis complicated by periappendiceal abscess. Eleven patients were reported to have undergone PD as well as antibiotic treatment. Among 35 patients who received nonoperative management with antibiotics only, 25 responded to antibiotics treatment, however, 10 subsequently required PD after initial treatment with antibiotics. Outcomes support that a majority of patients can effectively be managed with antibiotic therapy alone and hence, it is recommended as initial management. They recommend not delaying PD if clinical symptoms persist or the abscess remains unchanged to prevent potential complications and increased cost. Reimaging should be done 6 days following initiation of antibiotic therapy with ultrasound or MRI to recognize patients who would progress on antibiotics alone or who require drainage without delay. .