Can Acute Appendicitis be Treated by Antibiotics Alone?

Liu, Katherine; Ahanchi, Sadie; Pisaneschi, Mark; Lin, Irene; Walter, Robert

doi:10.1177/000313480707301118

Cited by 42 publications

(12 citation statements)

References 37 publications

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“…A negative appendicectomy is particularly hampered with problems5. Therefore in recent years there has been increased interest in antibiotic therapy as primary treatment6, and several studies have indicated that perforated appendicitis in children can be treated with antibiotics7–9. In addition, retrospective studies in adults with perforated appendicitis treated conservatively suggested that late recurrences exhibited a mild clinical course10, 11.…”

Section: Introductionmentioning

confidence: 99%

Randomized clinical trial of antibiotic therapy versus appendicectomy as primary treatment of acute appendicitis in unselected patients

Hansson

Körner

Khorram‐Manesh

et al. 2009

British Journal of Surgery

482

510

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Background: A trial in selected men suggested that antibiotic therapy could be an alternative to appendicectomy in appendicitis. This study aimed to evaluate antibiotic therapy in unselected men and women with acute appendicitis.Methods: Consecutive patients were allocated to study (antibiotics) or control (surgery) groups according to date of birth. Study patients received intravenous antibiotics for 24 h and continued at home with oral antibiotics for 10 days. Control patients had a standard appendicectomy. Follow-up at 1 and 12 months was carried out according to intention and per protocol.

show abstract

Section: Introductionmentioning

confidence: 99%

Randomized clinical trial of antibiotic therapy versus appendicectomy as primary treatment of acute appendicitis in unselected patients

Hansson

Körner

Khorram‐Manesh

et al. 2009

British Journal of Surgery

482

510

View full text Add to dashboard Cite

show abstract

“…Investigations into novel and efficient antibiotics have also provided new opportunities for nonsurgical treatment of appendicitis ( 8 ). Antibiotic therapy, the main nonoperative therapy, is becoming increasingly important in the treatment of acute appendicitis ( 9 , 10 ). Previous studies have shown that perforated appendicitis in children may be treated with antibiotics ( 11 – 13 ).…”

Section: Introductionmentioning

confidence: 99%

Meta-analysis of the therapeutic effects of antibiotic versus appendicectomy for the treatment of acute appendicitis

Liu

Zhang

et al. 2014

Experimental and Therapeutic Medicine

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Appendicectomy has been the gold standard treatment of acute appendicitis for more than a century, while nonoperative therapies, including antibiotics, have acquired increased interest in recent years. The present meta-analysis aimed to compare the therapeutic effects of antibiotics versus appendicectomy for the treatment of acute appendicitis. Medline, Embase and The Cochrane Library databases were searched. Prospective randomized controlled trials that compared antibiotic treatment with surgery were included. The outcomes evaluated included the time of hospital stay, complications and time to work. There were no statistically significant differences between the antibiotic and appendicectomy groups with regard to the time of hospital stay and complications. However, the time to work was significantly longer in the appendicectomy group when compared with the antibiotic group. In addition, the therapeutic effects of antibiotics and appendicectomy were comparable for the treatment of acute appendicitis.

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“…From all the meta-analyses included, there were eight different individual studies, in different combinations [ 20 – 27 ], with the majority being prospective studies (87.5 %). Only one meta-analysis included a retrospective study [ 23 ].…”

Section: Resultsmentioning

confidence: 99%

Antibiotics alone versus appendectomy to treat uncomplicated acute appendicitis in adults: what do meta-analyses say?

et al. 2015

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BackgroundPrimary appendectomy is the current standard of care for treating uncomplicated acute appendicitis, but interest in conservative treatment with antibiotics alone has been increasing in recent years. Clinical trials so far have shown controversial results.MethodsA series of meta-analyses were reviewed. Studies comparing surgery versus antibiotics alone for treating uncomplicated acute appendicitis in adults were included. Descriptive statistics and data on treatment effects were retrieved and summarized.ResultsThe conservative approach has a success rate of around 60 % and is associated with shorter pain duration, reduced analgesic medication, faster resolution of the inflammation process, lower expenses and quicker return to work. On the other hand, medical treatment leads to high (up to 20 %) readmission rates and more often requires surgery. An operative approach is associated with higher treatment success rates (>90 %) and very a low mortality rate.ConclusionBased on the current body of evidence, the use of antibiotics for primary treatment of uncomplicated acute appendicitis cannot be routinely recommended. Appendectomy remains the gold-standard treatment.

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Can Acute Appendicitis be Treated by Antibiotics Alone?

Cited by 42 publications

References 37 publications

Randomized clinical trial of antibiotic therapy versus appendicectomy as primary treatment of acute appendicitis in unselected patients

Randomized clinical trial of antibiotic therapy versus appendicectomy as primary treatment of acute appendicitis in unselected patients

Meta-analysis of the therapeutic effects of antibiotic versus appendicectomy for the treatment of acute appendicitis

Antibiotics alone versus appendectomy to treat uncomplicated acute appendicitis in adults: what do meta-analyses say?

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