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Antibiotics versus appendectomy in the management of acute appendicitis: a review of the current evidence

Fitzmaurice, Gerard, McWilliams, Billy, Hurreiz, Hisham and Epanomeritakis, Emanuel 2011. Antibiotics versus appendectomy in the management of acute appendicitis: a review of the current evidence. Canadian Journal of Surgery 54 (5) , pp. 307-314. 10.1503/cjs.006610

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Background: Acute appendicitis remains the most common cause of the acute abdomen in young adults, and the mainstay of treatment in most centres is an appendectomy. However, treatment for other intra-abdominal inflammatory processes, such as diverticulitis, consists initially of conservative management with antibiotics. The aim of this study was to determine the role of antibiotics in the management of acute appendicitis and to assess if appendectomy remains the gold standard of care. Methods: A literature search using MEDLINE and the Cochrane Library identified studies published between 1999 and 2009, and we reviewed all relevant articles. The articles were critiqued using the Public Health Resource Unit (2006) appraisal tools. Results: Our search yielded 41 papers, and we identified a total of 13 papers within the criteria specified. All of these papers, while posing pertinent questions and demonstrating the role of antibiotics as a bridge to surgery, failed to adequately justify their findings that antibiotics could be used as a definitive treatment of acute appendicitis. Conclusion: Appendectomy remains the gold standard of treatment for acute appendicitis based on the current evidence.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > RD Surgery
Language other than English: French
Publisher: Canadian Medical Association
ISSN: 0008-428X
Last Modified: 04 Jun 2017 03:58

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