Abstract
Introduction: Appendicitis is a commonly diagnosed source of abdominal pain treated with an appendectomy. Alternative treatments to surgery are not widely used and accepted. Treatment with antibiotics alone has been suggested as an alternative treatment to surgery for patients with uncomplicated appendicitis. Methods: A literature search was conducted using Pub Med and the keywords “appendicitis antibiotics.” A PICO search was also conducted on the trip database with keywords “(appendicitis)(antibiotic)(surgery or appendectomy).” Discussion: A small randomized control trial performed in the United States showed that 2 out of 15 patients had recurrent appendicitis after being treated only with antibiotics in a combination of inpatient and outpatient therapy. A much larger trial found that 70 out of 257 patients in the antibiotic only treatment group ended up needing an appendectomy after one year follow up, however patients treated only with antibiotics took less sick time from work. This study was extended and after 5 years 30 additional patients required surgery for recurrent appendicitis. Patient preferences were evaluated in two different studies and the results varied depending on the type of education given before the questionnaire. Conclusion: More research is needed to determine how antibiotics should factor into the treatment algorithm for appendicitis in the United States.