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Can acute appendicitis be treated by antibiotics alone?
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Hansson J, Korner U, Khorram-Manesh A, Solberg A, Lundholm K. Randomized clinical trial of antibiotic therapy versus appendicectomy as primary treatment of acute appendicitis in unselected patients. Br J Surg. 2009;96:473-81.
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Amoxicillin plus clavulanic acid versus appendicectomy for treatment of acute uncomplicated appendicitis: An open-label, non-inferiority, randomised controlled trial
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21550483 10.1016/S0140-6736(11)60410-8 1:CAS:528:DC%2BC3MXlslKmsb0%3D This randomised study claims to be the first based on proven uncomplicated appendicitis. It found 18 % of unexpected complicated appendicitis and 0 % negative appendectomies in the surgical group. The short term outcomes in terms of duration of pain, length of stay and duration of disability did not differ between the groups. The efficiency of the antibiotics treatment was 68 % at 1 year of follow up
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Vons C, Barry C, Maitre S, Pautrat K, Leconte M, Costaglioli B, et al. Amoxicillin plus clavulanic acid versus appendicectomy for treatment of acute uncomplicated appendicitis: an open-label, non-inferiority, randomised controlled trial. Lancet. 2011;377:1573-9. This randomised study claims to be the first based on proven uncomplicated appendicitis. It found 18 % of unexpected complicated appendicitis and 0 % negative appendectomies in the surgical group. The short term outcomes in terms of duration of pain, length of stay and duration of disability did not differ between the groups. The efficiency of the antibiotics treatment was 68 % at 1 year of follow up.
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Vons, C.1
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Antibiotics as first-line therapy for acute appendicitis: Evidence for a change in clinical practice
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Hansson J, Körner U, Ludwigs K, Johnsson E, Jönsson C, Lundholm K. Antibiotics as first-line therapy for acute appendicitis: evidence for a change in clinical practice. World J Surg. 2012;36:2028-36.
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Liu K, Fogg L. Use of antibiotics alone for treatment of uncomplicated acute appendicitis: a systematic review and meta-analysis. Surgery. 2011;150:673-83.
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Ansaloni L, Catena F, Coccolini F, Ercolani G, Gazzotti F, Pasqualini E, Pinna AD. Surgery versus conservative antibiotic treatment in acute appendicitis: a systematic review and meta-analysis of randomized controlled trials. Dig Surg. 2011;28:210-21.
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11
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Safety and efficacy of antibiotics compared with appendicectomy for treatment of uncomplicated acute appendicitis: Meta-analysis of randomised controlled trials
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22491789 10.1136/bmj.e2156 This systematic review and meta-analysis of randomised trials of non-surgical treatment of appendicitis with antibiotics conclude that "antibiotics can be used safely as primary treatment in patients presenting with acute uncomplicated appendicitis. An early trial of antibiotics merits consideration as the initial treatment option for uncomplicated appendicitis"
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Varadhan KK, Neal KR, Lobo DN. Safety and efficacy of antibiotics compared with appendicectomy for treatment of uncomplicated acute appendicitis: meta-analysis of randomised controlled trials. BMJ. 2012;344:e2156. This systematic review and meta-analysis of randomised trials of non-surgical treatment of appendicitis with antibiotics conclude that "antibiotics can be used safely as primary treatment in patients presenting with acute uncomplicated appendicitis. An early trial of antibiotics merits consideration as the initial treatment option for uncomplicated appendicitis".
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Varadhan, K.K.1
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12
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Antibiotic therapy versus appendectomy for acute appendicitis: A meta-analysis
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Varadhan KK, Humes DJ, Neal KR, Lobo DN. Antibiotic therapy versus appendectomy for acute appendicitis: a meta-analysis. World J Surg. 2010;34:199-209.
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Varadhan, K.K.1
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13
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Appendicitis and antibiotics
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Harrison PW. Appendicitis and antibiotics. Am J Surg. 1953;85:160-3.
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Five years of conservative treatment of acute appendicitis
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Non-operative treatment of suspected appendicitis in remote medical care environments: Implications for future spaceflight medical care
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Campbell MR, Johnston III SL, Marshburn T, et al. Non-operative treatment of suspected appendicitis in remote medical care environments: implications for future spaceflight medical care. J Am Coll Surg. 2004;198:822-30.
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18525466 10.1097/MPH.0b013e318168e7cb
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Wiegering VA, Kellenberger CJ, Bodmer N, Bergstraesser E, Niggli F, Grotzer M, Nadal D, Bourquin JP. Conservative management of acute appendicitis in children with hematologic malignancies during chemotherapy-induced neutropenia. J Pediatr Hematol Oncol. 2008;30:464-7.
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Nonsurgical treatment of appendiceal abscess or phlegmon: A systematic review and meta-analysis
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17968164 10.1097/SLA.0b013e31811f3f9f This systematic review and meta-analysis shows that non-surgical treatment of appendicitis phlegmone or circumscribed abscess with antibiotics is efficient and associated with shorter hospital stay and lower morbidity compared with open appendectomy
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Andersson RE, Petzold MG. Nonsurgical treatment of appendiceal abscess or phlegmon: a systematic review and meta-analysis. Ann Surg. 2007;246:741-8. This systematic review and meta-analysis shows that non-surgical treatment of appendicitis phlegmone or circumscribed abscess with antibiotics is efficient and associated with shorter hospital stay and lower morbidity compared with open appendectomy.
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17180556 10.1007/s00268-006-0056-y This is a review of the natural history of appendicitis. The implications for the diagnosis and management of patients with suspicion of appendicitis is discussed
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personal communication. Further details of this analysis can be obtained by request via rollanders@yahoo.com
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Andersson RE. personal communication. Further details of this analysis can be obtained by request via rollanders@yahoo.com.
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