Safety and efficacy of antibiotics compared with appendicectomy for treatment
of uncomplicated acute appendicitis: meta-analysis of randomised controlled trial
Varadhan K., Neal K., Lobo D.
BMJ 2012;344:e2156 doi: 10.1136/bmj.e2156 (Published 5 April 2012)
"This meta-analysis of four randomised controlled trials comparing antibiotic treatment and appendicectomy for uncomplicated acute appendicitis showed that antibiotics can be used safely as primary treatment in patients presenting with acute uncomplicated appendicitis. Antibiotic treatment was not associated with an increased perforation rate compared with surgery, nor were any significant differences seen in the length of stay or treatment efficacy between antibiotics and appendicectomy. An early trial of antibiotics merits consideration as the initial treatment option for uncomplicated appendicitis. The possibility that perforated and non-perforated appendicitis could have different patterns and pathological processes needs further evaluation. Perhaps, uncomplicated acute appendicitis should be treated akin to other conditions such as acute colonic diverticulitis in which antibiotic treatment plays an important role."