Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science


Emergency Medicine


Dr. Larry Herman


Background: Since the first appendectomy was carried out, surgery has proven to be the standard of care for acute appendicitis. Recent studies have pointed out that antibiotic therapy may be feasible for uncomplicated acute appendicitis. Antibiotic treatment is, however, reserved for specific conditions. In this article, the author reviews the literature to examine the evidence on using antibiotics as an alternative to appendectomy to treat acute appendicitis.

Method: A systematic literature search based on the term ‘appendicitis’ combined with the terms ‘complicated,’ ‘non-operative, ‘surgery,’ ‘therapy,’ ‘strategy,’ and ‘complicated’ was performed using MEDLINE, PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials databases for randomized, and non-randomized studies comparing surgical therapy appendectomy and antibiotic therapy for acute appendicitis.

Results: The author determined that there is a lack of evidence-based research to support the use of antibiotics as an alternative to appendectomy to treat acute appendicitis.

Conclusion: Antibiotic therapy may be a feasible option for treating acute appendicitis. However, further research is needed to determine the long-term outcomes of patients treated with antibiotics. Non-operative management for acute appendicitis does not increase the perforation rate in pediatric and adult patients on antibiotics. Laparoscopic appendectomy has been proven to have a high success rate and minimal significant complications.


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