Antibiotics for Acute Appendicitis.
Postoperative Complications; Antibiotics; Length of Stay; Decision Making; Appendectomy; Tomography; Human; Multicenter Studies; X-Ray Computed; Intravenous; Administration; Treatment Outcomes; Patient Education; Randomized Controlled Trials; Emergency Treatment; Antibiotics – Therapeutic Use; Appendicitis – Ultrasonography; Appendicitis – Drug Therapy; Appendicitis – Surgery
The article reports that patients with uncomplicated acute appendicitis can fair well without surgery as compared to clinical trial patients who underwent surgery, and states that patients had lower risk of complications during the one-year follow-up period.
Watkins Richard R
Internal Medicine Alert
2015
2015-09-15
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Early Uncomplicated Appendicitis-Who Can We Treat Nonoperatively?
Adult; Female; Male; Aged; Young Adult; Prospective Studies; Patient Selection; Drug Administration Schedule; Appendectomy; Injections; Human; Middle Age; Adolescence; Retrospective Design; Intravenous; Administration; Oral; Treatment Outcomes; Severity of Illness Indices; Antibiotics – Therapeutic Use; Ampicillin – Therapeutic Use; Appendicitis – Diagnosis; Appendicitis – Drug Therapy; Appendicitis – Surgery; Enzyme Inhibitors – Therapeutic Use; Penicillins – Therapeutic Use
This study evaluated nonoperative treatment for mild appendicitis and reviewed selection criteria to be used in introducing this option into clinical practice. A retrospective review of 73 consecutive cases of appendicitis treated by a single surgeon from 2011 to 2013 was completed. Patients who were diagnosed with mild appendicitis meeting the criteria of an APPENDICITIS scoring algorithm proposed in this manuscript were considered for nonoperative management. An additional 17 patients with mild appendicitis were offered and successfully treated nonoperatively between 2014 and 2016 and reviewed. Of these original 73 patients, 37 had moderate to severe appendicitis and directly underwent appendectomy. The remaining patients were diagnosed with mild appendicitis and considered eligible for nonoperative management. Of these, 14 patients were offered nonoperative therapy. Thirteen responded successfully; one patient responded partially, but later opted for surgery. In 2014, this scoring system and preliminary results were shared with the other surgeons in our department. Nonoperative management was then selectively adopted by a few of the surgeons from 2014 to 2016 with another 17 patients (APPENDICITIS score of 0 or 1) being offered and successfully managed nonoperatively. Patients with mild or early appendicitis can be successfully managed nonoperatively. A proposed APPENDICITIS scoring system may provide a helpful mnemonic for successfully selecting patients for this option.
Horattas Mark C; HORATTAS ILEANA K; VASILIOU ELYA M
American Surgeon
2018
2018-02
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).