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Studies have shown that most patients with uncomplicated acute appendicitis can be treated successfully in the short term with antibiotics. Nevertheless, most patients undergo surgery, in part because long-term recurrence rates are unknown. In this observational Finnish study, researchers extended a 1-year study (in which antibiotic therapy was compared with appendectomy; NEJM JW Gen Med Jul 15 2015 and JAMA 2015; 313:2340) to determine 5-year recurrence among 530 adults (median age, 35) with uncomplicated acute appendicitis confirmed by computed tomography (CT). The antibiotics group received intravenous ertapenem for 3 days, followed by oral levofloxacin and metronidazole for 7 days.
At 5 years, 39% of patients in the antibiotics group exp…