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 .
Long-Term Results Following Antibiotic Treatment of Acute Appendicitis in Adults
Background Antibiotic treatment of acute appendicitis has gained interest and inquiries . Reports have demonstrated both safety and high resolution of symptoms and inflammation following antibiotic treatment of appendicitis , but information on long-term results is required . Our present aim was therefore to evaluate long-term recurrence rate of initial antibiotics-alone treatment for suspected acute appendicitis . Methods Patients with favourable response to antibiotics in earlier r and omized ( RCT , n = 97 ) and population -based ( PBT , n = 342 ) studies as well as subsequently treated non-r and omized ( Non-R , n = 271 ) patients are evaluated for long-term risk to relapse dem and ing surgical appendectomy ; altogether 710 patients . Results Clinical characteristics among r and omized and non-r and omized patients were similar without any statistical difference according to abdominal symptoms and degree of systemic inflammation ( CRP , WCC ) when antibiotic treatment started . Females and males showed the same results . The median follow-up time was 2162 days ( 5.92 years ) , and the range across highest and lowest follow-up was 3495 days ( range 2–3497 ) for the entire group , without significant differences among subgroups ( RCT , PBT , Non-R ) . The cumulative probability for relapse of appendicitis dem and ing appendectomy was : 0.09 , 0.12 , 0.12 and 0.13 at 1- , 2- , 3- and 5-year follow-up , with a probability of 0.86 ± 0.013 without appendectomy after 8 years . This may imply an overall benefit of 60–70 % by antibiotics during expected 10-year follow-up accounting for initial treatment failures at 10–23 % in our published reports . Conclusion Antibiotic treatment is safe and effective as a first-line therapy in unselected adults with acute appendicitis with a risk around 15 % for long-term relapse following favourable initial treatment response
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 .