With significantly higher efficacy and low complication rates , appendectomy remains the most effective treatment for patients with uncomplicated AA .
BACKGROUND Acute appendicitis is the most common surgical diagnosis in young patients , with lifetime prevalence of about 7 % .
Debate remains on whether uncomplicated AA should be operated or not .
Aim of this meta- analysis of r and omized controlled trials was to assess current evidence on antibiotic treatment for uncomplicated AA compared to st and ard surgical treatment .
Burden of antimicrobial resistance in European hospitals: excess mortality and length of hospital stay associated with bloodstream infections due to Escherichia coli resistant to third-generation cephalosporins.
OBJECTIVES This study determined excess mortality and length of hospital stay ( LOS ) attributable to bloodstream infection ( BSI ) caused by third-generation-cephalosporin-resistant Escherichia coli in Europe . METHODS A prospect i ve parallel matched cohort design was used . Cohort I consisted of patients with third-generation-cephalosporin-resistant E. coli BSI ( REC ) and cohort II consisted of patients with third-generation-cephalosporin-susceptible E. coli BSI ( SEC ) . Patients in both cohorts were matched for LOS before infection with patients free of the respective BSI . Thirteen European tertiary care centres participated between July 2007 and June 2008 . RESULTS Cohort I consisted of 111 REC patients and 204 controls and cohort II consisted of 1110 SEC patients and 2084 controls . REC patients had a higher mortality at 30 days ( adjusted odds ratio = 4.6 ) and a higher hospital mortality ( adjusted hazard ratio = 5.7 ) than their controls . LOS was increased by 8 days . For SEC patients , these figures were adjusted odds ratio = 1.9 , adjusted hazard ratio = 2.0 and excess LOS = 3 days . A 2.5 times [ 95 % confidence interval ( 95 % CI ) 0.9 - 6.8 ] increase in all-cause mortality at 30 days and a 2.9 times ( 95 % CI 1.2 - 6.9 ) increase in mortality during entire hospital stay as well as an excess LOS of 5 days ( 95 % CI 0.4 - 10.2 ) could be attributed to resistance to third-generation cephalosporins in E. coli BSI . CONCLUSIONS Morbidity and mortality attributable to third-generation-cephalosporin-resistant E. coli BSI is significant . If prevailing resistance trends continue , high societal and economic costs can be expected . Better management of infections caused by resistant E. coli is becoming essential
With significantly higher efficacy and low complication rates , appendectomy remains the most effective treatment for patients with uncomplicated AA .
BACKGROUND Acute appendicitis is the most common surgical diagnosis in young patients , with lifetime prevalence of about 7 % .
Debate remains on whether uncomplicated AA should be operated or not .
Aim of this meta- analysis of r and omized controlled trials was to assess current evidence on antibiotic treatment for uncomplicated AA compared to st and ard surgical treatment .