Although pain was a common criterion for nonresponse and appendectomy , analgesic regimens were poorly described .
BACKGROUND Meta-analyses and a recent guideline acknowledge that conservative management of uncomplicated appendicitis with antibiotics can be successful for patients who wish to avoid surgery .
However , guidance as to specific management does not exist .
Efficacy of Short-Term Antibiotic Therapy for Consecutive Patients with Mild Appendicitis
Although antibiotic therapy seemed to be a safe treatment option for acute appendicitis , indications of this treatment have not been fully evaluated . We hypothesized that clinical and radiologic mild appendicitis may be a c and i date for short-term antibiotic therapy . The purpose of present study was to examine the efficacy and the recurrence rate of short-term antibiotic therapy for consecutive patients with mild appendicitis . A prospect i ve observational study was conducted over 3 years . The mild appendicitis was defined as the intermediate Alvarado score ( 4 - 8 ) and dilated appendix from 6 mm to 10 mm in radiologic study . All patients received initial antibiotics administration with clinical observation during 48 hours . The failure to respond to therapy and the incidence of recurrence were assessed . There were 107 enrolled patients with the mean Alvarado score of 6 ± 1 and the mean appendiceal diameter of 7.4 ± 1 mm . Of these , 97 ( 91 % ) exhibited improved symptoms and were discharged . The remaining 10 patients underwent surgery because of clinical aggravation , and pathology revealed true appendicitis in six of them . Of the 97 patients in whom the initial treatment was successful , five patients ( 5 % ) exhibited recurrent symptoms during a median follow-up period of 18 months . Of these five patients , three were treated with surgery ( all true appendicitis ) , and the remaining two were once again treated with antibiotics . Patients with suspected appendicitis , those in whom mild appendicitis was diagnosed after clinical and radiologic evaluations , were found to benefit from short-term antibiotic therapy
Although pain was a common criterion for nonresponse and appendectomy , analgesic regimens were poorly described .
BACKGROUND Meta-analyses and a recent guideline acknowledge that conservative management of uncomplicated appendicitis with antibiotics can be successful for patients who wish to avoid surgery .
However , guidance as to specific management does not exist .