Opinion EDITORIAL Evolving Issues in the Use of Antibiotics for the Treatment of Uncomplicated Appendicitis Peter C. Minneci, MD, MHSc; Katherine J. Deans, MD, MHSc Over the past decade there has been considerable discussion confirmed the safety and effectiveness of nonoperative man- regarding whether antibiotics alone should be offered as a agement of appendicitis (676 of 776 participants [87%] com- pleted 90-day follow-up), with a 90-day success rate of 71%. treatment option to patients with uncomplicated appendici- tis. Recent evidence has suggested the answer to this ques- Compared with surgery (656 of 776 participants [85%] com- tion is yes. Results from sev- pleted 90-day follow-up), nonoperative management was eral large trials, including the associated with decreased disability (5.3 vs 8.7 missed Related article Appendicitis Acuta (APPAC) worked days) and similar treatment-associated complications II trial reported in this issue of JAMA, have generated robust (3% vs 3%) and quality of life (European Quality of Life–5 evidence for the effectiveness and safety for nonoperative Dimensions scores at 30 days: 0.92 vs 0.91). management of uncomplicated appendicitis for both adults The APPAC II trial results published in this issue of JAMA 1-4 and children. further confirm and extend the effectiveness of antibiotics
JAMA – American Medical Association
Published: Jan 26, 2021
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