Abstract Background and Aim Acute appendicitis is the most common surgical emergency in the paediatrics. Complicated appendicitis often involves perforation, requiring a longer course of antibiotics post-appendicectomy [1]. There is considerable variability on post-operative antibiotic regimes and duration within hospital trusts with no national guidelines. Local Trust-based consensus [2] recommends a 5-day course IV co-amoxiclav with American Paediatric Surgical Association guidelines suggesting oral conversion if IV antibiotic duration is less than 5 days [3, 4]. Therefore, we measured compliance with local and international guidelines. Methods Paediatric patients aged 5-17 years were selected for the study using ICD-10 codes for ‘Perforated Appendicitis’ (K35.2 and K35.3). Patients were included if they had operative management for perforated appendicitis between 1 April 2021 and 31 March 2022. Key parameters collated included; re-admission, duration of re-admission, complication, post-operative antibiotic use (selection, intravenous/oral dose and duration of use). Results Twenty-six paediatric appendicectomies for perforated appendicitis occurred within the time frame. Nine had IV antibiotics for >5 days, of this cohort, 7 had oral conversion and completed 2-5 days of oral antibiotics with re-admission rate 33%. Eleven had IV antibiotics for < 5 days with oral conversion for 4-7 days, readmission rate was 18.2% on days 4 & 5 respectively. Six had IV antibiotics for <5 days with no oral conversion and no patients were re-admitted. Conclusions A longer duration of antibiotics with an earlier conversion from IV to oral, reduced readmission rates. However, greater research with more participants and standardised antibiotics can explore other influencing factors.