Abstract
Background Although appendicectomy is still the classical and standard treatment for acute appendicitis, initial conservative antibiotic only treatment for simple uncomplicated cases has been proposed and tried as a feasible and effective approach. The objective of this study was to evaluate the efficacy and outcomes of antibiotics treatment for acute simple uncomplicated appendicitis. Methods This is a prospective controlled nonrandomized study in which a total of 156 patients whose ages range from 16 to 54 years presenting with clinical diagnosis of acute uncomplicated appendicitis were assigned for conservative antibiotics treatment, which consists of ceftriaxone I gram twice daily and metronidazole infusions, 500 mg in 100 ml, 3 times daily for 48 to 72 hours to be converted on oral antibiotics after clinical improvement for 5 to 7 days. Patients who failed to initial conservative treatment and those who had recurring symptoms of appendicitis were presented for appendectomy. Results Antibiotic treatment was successful and feasible in 138 (88.5%) patients. Progression of the signs and symptoms despite full medical treatment was observed in 11 (7%) patients during the same admission. Further 7 (4.5%) patients showed recurrence of the symptoms during follow-up period of 6–12 months after successful initial conservative treatment and also proceeded for appendicectomy. Conclusion Nonoperative antibiotic treatment of acute simple appendicitis is safe, feasible, and effective for properly selected cases, thus avoiding unnecessary surgery with its possible complications.
Highlights
Acute appendicitis is the most frequent emergency in the general surgical practice worldwide. e life-time incidence of acute appendicitis is estimated to be one in ten people
Appendicectomy is simple and safe procedure, it can result in several complications such as wound infection, pelvic abscess, bowel obstruction due to adhesion, pneumonia, and enterocutaneous fistula [3]. ere has been growing evidence and trend toward primary antibiotic treatment that has gained more acceptance in the last few years for selected patients with uncomplicated acute appendicitis
E diagnosis of acute uncomplicated appendicitis depends on history and clinical exam, laboratory investigations, mainly the inflammatory markers triad, and imaging, mainly ultrasound, which was done for all patients and CT scan which was done only for query cases (46 patients)
Summary
Acute appendicitis is the most frequent emergency in the general surgical practice worldwide. e life-time incidence of acute appendicitis is estimated to be one in ten people. It has been found recently that such progressive nature of acute appendicitis and perforation is quite uncommon, especially in young and adult patients, and the majority of the cases are simple and uncomplicated [1, 2]. E main purpose of this work was to assess the effectiveness and feasibility of antibiotic conservative approach as the sole treatment modality of Surgery Research and Practice simple uncomplicated appendicitis in terms of short-term and long-term outcomes, complication, length of the hospital stay, sick leave, and overall effectiveness. Appendicectomy is still the classical and standard treatment for acute appendicitis, initial conservative antibiotic only treatment for simple uncomplicated cases has been proposed and tried as a feasible and effective approach. Nonoperative antibiotic treatment of acute simple appendicitis is safe, feasible, and effective for properly selected cases, avoiding unnecessary surgery with its possible complications
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
