Dr. Tom Colletti
Antibiotics provide a non-surgical treatment option for patients who require delayed surgical intervention. Historically, the military operates in austere locations, equating to delayed evacuation and surgical intervention. As our potential adversaries challenge the U.S. for air superiority, healthcare providers must prepare for delayed evacuation and treatment. Of the 31,610 cases of appendicitis within the active duty and reserve components, 73.4 percent were uncomplicated. A search was conducted using PubMed and Google Scholar. Articles included participants between 18 and 65 years old, diagnosed with acute uncomplicated appendicitis, and not at risk for major complications. Articles were excluded with poor follow-up, appendectomies as the primary treatment, and immunocompromised. This literature review included three randomized clinical trials and one systematic review and meta-analysis that addressed the use of antibiotics in adult patients to manage acute uncomplicated appendicitis. A total of 1,143 participants were treated with either antibiotics or appendectomies comparatively. Patients in the antibiotic treatment group received medications intravenously, followed by outpatient oral antibiotics. Antibiotics provide a safe, non-surgical treatment for selective patients when immediate surgical intervention is not feasible and unfavorable; however, caution is needed when selecting patients for this treatment option. Risks must be considered for relapse and progression to major complications.
Smith TS. Management of Acute Uncomplicated Appendicitis with Antibiotics: A Review. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2023; 5(2).
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