A Meta-Analysis of Antibiotics Versus Surgery for the Treatment of Acute Appendicitis
American Journal of Bioscience and Bioengineering
Volume 5, Issue 3, June 2017, Pages: 75-82
Received: Jul. 19, 2017;
Accepted: Jul. 31, 2017;
Published: Aug. 18, 2017
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Luai Fadi Madanat, Department of Surgery, School of Medicine, University of Jordan, Amman, Jordan
Dina Wahib Shaban, Department of Surgery, School of Medicine, University of Jordan, Amman, Jordan
Hamzeh Mohamad Naghawi, Department of Surgery, School of Medicine, University of Jordan, Amman, Jordan
Haneen Samir Saker, Department of Surgery, School of Medicine, University of Jordan, Amman, Jordan
Moaath Alsmady, Department of Surgery, School of Medicine, University of Jordan, Amman, Jordan
Handan Ankarali, Department of Biostatistics, School of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
Tunc Eren, Department of General Surgery, School of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
Orhan Alimoglu, Department of General Surgery, School of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
Appendectomy is the mainstay of treatment for acute appendicitis. Considering the complications of surgery, antibiotic treatment has also been gaining increasing interest in cases of acute appendicitis. This study aimed to compare the efficacy of antibiotics to surgery for acute uncomplicated appendicitis. The PubMed, Medline, Medscape and Cochrane databases were searched for studies comparing antibiotics versus surgery. The six outcome measures identified were thirty-day post-therapeutic peritonitis, length of hospital stay, prevalence of total complications, prevalence of normal appendix, prevalence of mean duration of pain and duration of disability. Five prospective RCTs with a total of 1430 patients (644 in the antibiotic group and 786 in the surgical group) were included in this study. Antibiotic treatment had a success rate of 75.3%. Regarding overall mean duration of disability, the antibiotic group had a significantly shorter duration of disability than that of the surgery group (P < 0.05). The total number of complications in the antibiotic group was 3.6% while that of the surgical group was 11.6%. The overall difference for mean duration of pain, and length of hospital stay between antibiotic therapy and surgery were not found to be statistically significant (P > 0.05). Although the conservative approach has a success rate lower than appendectomy, it is a possible alternative in certain clinical scenarios. Appendectomy remains the mainstay treatment for acute appendicitis. However, additional studies clarifying the certain etiologies of appendicitis that are responsive to antibiotic treatment are needed to further support its use.
Luai Fadi Madanat,
Dina Wahib Shaban,
Hamzeh Mohamad Naghawi,
Haneen Samir Saker,
A Meta-Analysis of Antibiotics Versus Surgery for the Treatment of Acute Appendicitis, American Journal of Bioscience and Bioengineering.
Vol. 5, No. 3,
2017, pp. 75-82.
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