Antibiotics as First‐line Therapy for Acute Appendicitis: Evidence for a Change in Clinical Practice

Abstract

This population-based study confirms previous results of randomized studies. Antibiotic treatment can be offered as the first-line therapy to a majority of unselected patients with acute appendicitis without medical drawbacks other than the unknown risk for long-term relapse, which must be weighed against the unpredicted but well-known risk for serious major complications following surgical intervention.

The Systemic Inflammatory Response in Patients with Appendicitis: a Progressive Phenomenon

“…However, although these data support the importance of progressive inflammatory reaction to appendicitis, the proper inflammatory progression has not been characterized [12]. This is of relevance because of recent claims for conservative antibiotic management of appendicitis [13][14][15][16][17][18][19], the high rate of conservative treatment failure, and recurrent appendicitis indicating a problem with the design of these studies which have used unselected consecutive samples with various different diagnostic intervals, not taking into account the fact that appendicitis is an evolving disease that worsens with the passing of time. The inflammatory response to appendicitis is not uniformly similar in all patients; consequently, the individual particular response to injury may be considered as a source of bias.…”

Progresión De La Respuesta Inflamatoria Sistémica en Pacientes Con Apendicitis

“…La información publicada demuestra la importancia de la reacción inflamatoria progresiva a apendicitis, la cual no ha sido propiamente descrita y caracterizada 14 . Este hecho es relevante debido a las recientes publicaciones sobre tratamiento conservador en apendicitis [16][17][18][19][20][21][22] , en estos casos la elevada tasa de fracaso del tratamiento y apendicitis recurrente revelan fallas en el diseño de estos estudios, los que utilizaron muestras no seleccionadas de pacientes con diferentes intervalos de diagnóstico sin tomar en cuenta la naturaleza evolutiva de esta patología.…”

A Rare Case Report: Stump Appendicitis

“…Altı hafta içinde hastanın elektif şartlarda operasyona hazırlanması sağlanırken bu sırada kolonoskopi ile çekal bir patoloji olup olmadığının kontrol edilmesi de önerilmektedir. 10 Biz hastamızın karın ağrısının ileri derece olması ve akut batın tablosu olması nedeniyle laparoskopik cerrahiyi tercih ettik ve laparoskopik olarak tamamlayıcı apandektomiyi komplikasyonsuz sonlandırdık.…”